Provider Demographics
NPI:1962789941
Name:DONOHUE, ANN MARIE (PHD)
Entity type:Individual
Prefix:DR
First Name:ANN MARIE
Middle Name:
Last Name:DONOHUE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:349 N KESWICK AVE
Mailing Address - Street 2:
Mailing Address - City:GLENSIDE
Mailing Address - State:PA
Mailing Address - Zip Code:19038-4217
Mailing Address - Country:US
Mailing Address - Phone:215-803-6387
Mailing Address - Fax:
Practice Address - Street 1:349 N KESWICK AVE
Practice Address - Street 2:
Practice Address - City:GLENSIDE
Practice Address - State:PA
Practice Address - Zip Code:19038-4217
Practice Address - Country:US
Practice Address - Phone:215-803-6387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005970L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist