Provider Demographics
NPI:1750635413
Name:DONOVAN, RENEE S (LMFT)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:S
Last Name:DONOVAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 NICOL DR
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19606-3514
Mailing Address - Country:US
Mailing Address - Phone:610-304-2989
Mailing Address - Fax:
Practice Address - Street 1:516 KENHORST BLVD
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19611-1716
Practice Address - Country:US
Practice Address - Phone:610-777-0705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-02
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000689106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist