Provider Demographics
NPI:1033798368
Name:DONAHUE, KELSEY ANNE (MED)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:ANNE
Last Name:DONAHUE
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14555 CREEK CLUB DR
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-4301
Mailing Address - Country:US
Mailing Address - Phone:770-712-9169
Mailing Address - Fax:
Practice Address - Street 1:555 SUN VALLEY DR STE 2
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-5612
Practice Address - Country:US
Practice Address - Phone:678-381-1687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-05
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health