Individual
BETSY JOANNE DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, MSW
Contact information
Practice address
2704 N MAIN ST, ROCKFORD, IL 61103-3112
(815) 391-1000
Mailing address
1021 N MULFORD RD, ROCKFORD, IL 61107-3877
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
149022297
IL
Other
Enumeration date
07/19/2018
Last updated
07/10/2020
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