Individual
CAROLYN DONOVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18 FORD AVE, TROY, NY 12180-5802
(518) 229-8386
Mailing address
53 CENTRAL AVE, TROY, NY 12180-7210
(518) 229-8386
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NY
252Y00000X
Early Intervention Provider Agency
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0212
—
NY
Enumeration date
04/20/2016
Last updated
04/20/2021
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