Kyle Donahue
Counselor, Mental Health in Bloomington, IL. Individual provider (NPI-1).
NPI number1154041069
StatusActive
Last updated in NPPESAug 31, 2022
Details
- NPI
- 1154041069
- Entity type
- Individual (NPI-1)
- Name
- Kyle Donahue
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 31, 2022
- Certification date
- Aug 31, 2022
- Last updated
- Aug 31, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
Practice location
108 W Market StBloomington, IL 61701-3918
Phone 309-827-5351
Mailing address
108 W Market StBloomington, IL 61701-3918
Phone 309-827-5351
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