Doctor Name: | RICHARD DONHAM |
NPI Number: | 1114091196 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | 3746336004 |
Business Practice Address: | 198 East Center Street Moab, UT - 84532 |
Business Phone Number: | 4352596131 |
Business Fax Number: | 4352595369 |
Mailing Address: | Po Box 867, PRICE |
State: | UT |
Postal Code: | 84501 |
Phone Number: | 4356377200 |
Fax Number: | 4356372377 |
NPI Enumeration Date: | 11/20/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 3746336004 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |