Provider Demographics
NPI:1467564419
Name:DONOVAN, SANDY CRISTINE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SANDY
Middle Name:CRISTINE
Last Name:DONOVAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7400 MERTON MINTER BLVD
Mailing Address - Street 2:MAIL CODE 122
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229
Mailing Address - Country:US
Mailing Address - Phone:210-617-5300
Mailing Address - Fax:210-617-5366
Practice Address - Street 1:7400 MERTON MINTER BLVD
Practice Address - Street 2:MAIL CODE 122
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229
Practice Address - Country:US
Practice Address - Phone:210-617-5300
Practice Address - Fax:210-617-5366
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX387271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical