Individual
KERRY DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
176 WORCESTER PROVIDENCE TPKE, SUTTON, MA 01590-1901
(774) 482-1110
Mailing address
12 BAINBRIDGE RD, WORCESTER, MA 01602-2212
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-33061
MA
2355S0801X
Speech-Language Assistant
SP-1233-SA
MA
Other
Enumeration date
10/08/2014
Last updated
03/21/2022
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