Provider Demographics
NPI:1922653260
Name:DONAHUE, CHRISTINA ROBIN (MSW, CSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:ROBIN
Last Name:DONAHUE
Suffix:
Gender:F
Credentials:MSW, CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:743 RAND RD
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-8331
Mailing Address - Country:US
Mailing Address - Phone:270-993-2849
Mailing Address - Fax:
Practice Address - Street 1:1100 WALNUT ST STE 112
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-2956
Practice Address - Country:US
Practice Address - Phone:270-689-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-05
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY54391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical