Donovan, Paul Bernard

Donovan, Paul Bernard is an individual health care provider with primary practice located at 1640 Old Pecos Trl Suite B, Santa Fe NM 87505-4776. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Health Service, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Donovan, Paul Bernard can be contacted via phone (505) 986-8866.

Contact Information

Primary practice address
1640 Old Pecos Trl Suite B Santa Fe NM 87505-4776
Phone: (505) 986-8866
Fax: (505) 983-1891
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Health Service 103TH0100X 675 New Mexico
Behavioral Health & Social Service Providers / Clinical 103TC0700X #675 New Mexico

Profile Details

NPI number 1366493769
LBN Legal business name Donovan, Paul Bernard
Credentials PH.D
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2006
Last updated Dec 29th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366493769 NPPES
New Mexico MEDICAID S3976.

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