Provider Demographics
NPI:1487436994
Name:CAROTHERS, DONNA MARIA
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:MARIA
Last Name:CAROTHERS
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 1:3965 PARLIAMENT PL APT 95
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-4334
Mailing Address - Country:US
Mailing Address - Phone:937-301-5493
Mailing Address - Fax:
Practice Address - Street 1:3965 PARLIAMENT PL APT 95
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-4334
Practice Address - Country:US
Practice Address - Phone:937-301-5493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH172A00000X172A00000X
OH385HR2060X385HR2060X
OH3747P1801X376J00000X
OH376J00000X376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No172A00000XOther Service ProvidersDriver
No376J00000XNursing Service Related ProvidersHomemaker