Individual
SAMANTHA DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
515 MOE RD, CLIFTON PARK, NY 12065-3821
(518) 280-4294
Mailing address
9 DESSON AVE APT 1, TROY, NY 12180-5201
(518) 860-2793
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
011578-01
NY
Other
Enumeration date
10/02/2024
Last updated
10/02/2024
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