Organization
LEO P DONOVAN JR PHD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEO P DONOVAN JR. PH.D. (MANAGER)
(203) 359-4560
Entity
Organization
Contact information
Practice address
239 HAMILTON AVE APT 8, STAMFORD, CT 06902-3480
(203) 359-4560
(203) 359-4913
Mailing address
239 HAMILTON AVE APT 8, STAMFORD, CT 06902-3480
(203) 359-4560
(203) 359-4913
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
560
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004183274
—
CT
01
—
1316016611
NPI
—
Enumeration date
03/22/2011
Last updated
04/17/2011
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