Individual
AMY J DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8014 BETHEL RD, ARPIN, WI 54410-9558
(715) 652-2103
Mailing address
7959 EVERGREEN ST, HEWITT, WI 54441-9036
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1287-27
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40790900
—
WI
Enumeration date
04/10/2007
Last updated
11/13/2012
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