Individual
TIMOTHY JAY DONAHUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BGS BSRCE CADC
Contact information
Practice address
420 KENNEDY ST, BURLINGTON, KS 66839-1120
(620) 364-2606
(620) 364-2551
Mailing address
420 KENNEDY ST, BURLINGTON, KS 66839-1120
(620) 364-2606
(620) 364-2551
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AAPS
AAPS
KS
01
—
BSRCE
BSRCE
KS
Enumeration date
05/22/2008
Last updated
05/22/2008
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