MEDICARE: MRS. DONNA M HUNTER LCSW

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	1041C0700X	Clinical Social Worker	SW0003309	FL
2	1041C0700X	Clinical Social Worker	2505-C	AR
3	1041C0700X	Clinical Social Worker	LCSW-38374	ID

General Provider Information

NPI Number	:	1558350306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DONNA M HUNTER LCSW

Provider Business Mailing Address
First Line	:	1220 GARRETT ST
Second Line	:
City	:	MOUNTAIN HOME
State	:	ID
Zip	:	83647-4374
Country	:	US
Telephone Number	:	479-206-3627
Fax Number	:

Provider Business Practice Location Address
First Line	:	1993 E 8TH N
Second Line	:
City	:	MOUNTAIN HOME
State	:	ID
Zip	:	83647-2326
Country	:	US
Telephone Number	:	479-206-3627
Fax Number	:	866-584-0449

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

Provider Enumeration Date	:	10/14/2005
Last Update Date	:	03/13/2020

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