Provider Demographics
NPI:1639345762
Name:NOVIAN, DONALD ALLEN (PHD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:ALLEN
Last Name:NOVIAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8213 FREDERICKSBURG RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3355
Mailing Address - Country:US
Mailing Address - Phone:210-831-1282
Mailing Address - Fax:210-615-1767
Practice Address - Street 1:8213 FREDERICKSBURG RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3355
Practice Address - Country:US
Practice Address - Phone:210-831-1282
Practice Address - Fax:210-615-1767
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61033101YP2500X
TX200949106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional