Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 009110L | PA |
N | 103T00000X | Psychologist | 009110L | PA |
N | 103TA0700X | Adult Development & Aging Psychologist | 009110L | PA |
N | 103G00000X | Clinical Psychologist | 009110L | PA |
N | 103TC0700X | Clinical Psychologist | 009110L | PA |
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 009110L | PA |
N | 103TM1800X | Intellectual & Developmental Disabilities | 009110L | PA |
NPI | 1144331612 |
---|---|
Provider Name | Dr. Patricia A Donoghue |
First Address | Uwchland, PA 19480-0412 |
Second Address | Glenmoore, PA 19343-9528 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 17/01/2017 |