Provider Demographics
NPI:1467209668
Name:DONAHUE, HEATHER RAY
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:RAY
Last Name:DONAHUE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7264 ANTIGUA PL
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-2423
Mailing Address - Country:US
Mailing Address - Phone:303-907-9552
Mailing Address - Fax:
Practice Address - Street 1:7264 ANTIGUA PL
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-2423
Practice Address - Country:US
Practice Address - Phone:303-907-9552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-04
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician