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Individual
TIMOTHY JAY DONAHUE
Active
Individual
TIMOTHY JAY DONAHUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BGS BSRCE CADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
NULL
390200000X
Student in an Organized Health Care Education/Training Program
—
NULL
Other
Enumeration date
05/22/2008
Last updated
05/22/2008
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