Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 165929 | KY |
NPI | 1003178864 |
---|---|
Provider Name | Janna Donovan |
First Address | Louisville, KY 40242-3034 |
Second Address | Louisville, KY 40206-1033 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2012 |
Last Update Date | 08/06/2021 |