Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | C009145 | NC |
NPI | 1003189150 |
---|---|
Provider Name | Mr. Timothy P Donahoe |
First Address | Durham, NC 27707 |
Second Address | Durham, NC 27707 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2012 |
Last Update Date | 10/03/2017 |