Healthcare Provider Details

I. General information

NPI: 1104832914
Provider Name (Legal Business Name): DONNA LYNNE HUNSTOCK LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 S TYLER ST
COVINGTON LA
70433-3036
US

IV. Provider business mailing address

101 MAGNOLIA GARDENS DR
COVINGTON LA
70435-9524
US

V. Phone/Fax

Practice location:
  • Phone: 985-630-2400
  • Fax: 985-892-5664
Mailing address:
  • Phone: 985-630-2400
  • Fax: 985-892-5664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number2777
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: