Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 3505 | AZ |
NPI | 1083630412 |
---|---|
Provider Name | Dr. Kathleen Bridget Donaghy |
First Address | Scottsdale, AZ 85259-4938 |
Second Address | Scottsdale, AZ 85259-4938 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
AZ0618420 | BC/BS (01) | AZ |