Individual
JENNIFER DONAHUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6560 E NUTTAL DR, KINGMAN, AZ 86401-8340
(302) 304-0625
Mailing address
6560 E NUTTAL DR, KINGMAN, AZ 86401-8340
(302) 304-0625
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TSLP9120
AZ
Other
Enumeration date
12/01/2014
Last updated
12/01/2014
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