Provider Demographics
NPI:1932297686
Name:DONAHUE, STEPHEN P (MA)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:P
Last Name:DONAHUE
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 LAWN AVE
Mailing Address - Street 2:
Mailing Address - City:SELLERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18960-1549
Mailing Address - Country:US
Mailing Address - Phone:215-257-6551
Mailing Address - Fax:215-453-5181
Practice Address - Street 1:807 LAWN AVE
Practice Address - Street 2:
Practice Address - City:SELLERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18960-1549
Practice Address - Country:US
Practice Address - Phone:215-257-6551
Practice Address - Fax:215-453-5181
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS008101L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist