Individual
MR. MARK DONAHUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
130 BIRGE ST, BRATTLEBORO, VT 05301-6460
(802) 254-3742
Mailing address
97 WINTER ST, BRATTLEBORO, VT 05301-6666
(802) 451-1084
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089001259
VT
Other
Enumeration date
11/03/2008
Last updated
02/12/2009
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