Individual
SAMANTHA DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4385 MARYLAND AVE, SAINT LOUIS, MO 63108-2703
(504) 896-2345
Mailing address
1538 LOUISIANA AVE, NEW ORLEANS, LA 70115-3553
(504) 896-2345
(504) 896-2240
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
376G00000X
Nursing Home Administrator
Primary
8079
MO
Other
Enumeration date
07/19/2016
Last updated
10/24/2024
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