Individual
MRS. LISA A DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
62 PROVIDENCE PIKE STE E, PUTNAM, CT 06260-2415
(860) 805-0759
Mailing address
3 BAILEY WOODS RD, BROOKLYN, CT 06234-2405
(860) 774-6765
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/18/2019
Last updated
11/18/2019
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