Individual
ELIZABETH DONAHUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
376 HALE ST, BEVERLY, MA 01915-2098
(978) 232-2340
Mailing address
376 HALE ST, BEVERLY, MA 01915-2098
(978) 232-2340
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
643
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
643
COMMONWEALTH OF MASSACHUSETTS/DIVISION OF PROFESSIONAL LICENSURE
MA
Enumeration date
08/12/2019
Last updated
08/12/2019
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