Provider Demographics
NPI:1447471867
Name:DONOHUE, KRISTEN KENNEY (MS,PT)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:KENNEY
Last Name:DONOHUE
Suffix:
Gender:F
Credentials:MS,PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 MUSKET CT
Mailing Address - Street 2:
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914-3759
Mailing Address - Country:US
Mailing Address - Phone:215-491-0781
Mailing Address - Fax:
Practice Address - Street 1:605 MUSKET CT
Practice Address - Street 2:
Practice Address - City:CHALFONT
Practice Address - State:PA
Practice Address - Zip Code:18914-3759
Practice Address - Country:US
Practice Address - Phone:215-491-0781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT016895225100000X
NJ40QA00715000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist