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Individual

ANDREW DONOVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LAC

Contact information

Practice address
1502 MARY KAY BLVD, BENTON, AR 72015
(501) 315-3344
Mailing address
PO BOX 1589, BENTON, AR 72018-1589
(501) 315-3344

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
A1810152
AR
101YP2500X
Professional Counselor
Primary
P2110003
AR
171M00000X
Case Manager/Care Coordinator

Other

Enumeration date
02/27/2017
Last updated
01/12/2022
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