| Doctor Name: | MS. DONNA M DEGEORGE |
| NPI Number: | 1104135367 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PCC, LICDC |
| License Number: | 081002 |
| Business Practice Address: | 2801 C Ct Ashtabula, OH - 440044577 |
| Business Phone Number: | 4409984210 |
| Business Fax Number: | 4409986489 |
| Mailing Address: | 2330 Columbus Ave, ASHTABULA |
| State: | OH |
| Postal Code: | 440045039 |
| Phone Number: | 4409984210 |
| Fax Number: | 4409986489 |
| NPI Enumeration Date: | 10/05/2010 |
| NPI Last Update Date: | 10/05/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 081002 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |