Individual
MRS. AMY DONATHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
4950 OLD COLLINSVILLE RD, SWANSEA, IL 62226-2025
(618) 624-4060
Mailing address
320 RIDGE DR, SMITHTON, IL 62285-1418
(618) 616-0944
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
166.001179
IL
Other
Enumeration date
05/08/2018
Last updated
05/08/2018
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