Individual
ELAINE M DONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
380 SUWANNEE TRAIL STREET, BOWLING GREEN, KY 42103
(270) 901-5000
(270) 842-0054
Mailing address
247 BROADWAY ST, SMITHS GROVE, KY 42171-8204
(270) 901-5000
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30604011
—
KY
Enumeration date
03/16/2007
Last updated
02/22/2013
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