Provider Demographics
NPI:1043870728
Name:DONOVAN, SARAH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:DONOVAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 FIELDSTONE TRL
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-8245
Mailing Address - Country:US
Mailing Address - Phone:518-428-7430
Mailing Address - Fax:
Practice Address - Street 1:5151 FIELDSTONE TRL
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-8245
Practice Address - Country:US
Practice Address - Phone:518-428-7430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-16
Last Update Date:2019-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020145103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent