Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 020145 | NY |
NPI | 1043870728 |
---|---|
Provider Name | Dr. Sarah Donovan |
First Address | Canandaigua, NY 14424-8245 |
Second Address | Canandaigua, NY 14424-8245 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2019 |
Last Update Date | 16/06/2019 |