MEDICARE: LAUREN DONOHER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1255064663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN DONOHER

Provider Business Mailing Address
First Line	:	12 GREENWOOD DR
Second Line	:
City	:	BORDENTOWN
State	:	NJ
Zip	:	08505-2720
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12 GREENWOOD DR
Second Line	:
City	:	BORDENTOWN
State	:	NJ
Zip	:	08505-2720
Country	:	US
Telephone Number	:	920-312-1070
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/04/2022
Last Update Date	:	07/04/2022

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Directions to “ LAUREN DONOHER ” Practice Location

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