Individual
BREANNA DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5130 S PECOS RD, LAS VEGAS, NV 89120-1248
(702) 560-5973
Mailing address
7860 BLUE BROOK DR, LAS VEGAS, NV 89147-4257
(702) 465-0353
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1014M0800X
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982975009
—
NV
Enumeration date
12/18/2013
Last updated
12/18/2013
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