Provider Demographics
NPI:1588383145
Name:CANIPE, DONNA (LMP)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:CANIPE
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MALLETT WAY STE 102
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910-6066
Mailing Address - Country:US
Mailing Address - Phone:843-707-2826
Mailing Address - Fax:843-706-2178
Practice Address - Street 1:1 MALLETT WAY STE 102
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-6066
Practice Address - Country:US
Practice Address - Phone:843-707-2826
Practice Address - Fax:843-706-2178
Is Sole Proprietor?:No
Enumeration Date:2022-08-25
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8296225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist