Healthcare Provider Details

I. General information

NPI: 1952813057
Provider Name (Legal Business Name): DONNELLA MARIE HILBURN MED, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2017
Last Update Date: 04/18/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E STATE ST STE D
ATHENS OH
45701-1870
US

IV. Provider business mailing address

2222 FAR HILLS AVE UNIT 2
OAKWOOD OH
45419-2545
US

V. Phone/Fax

Practice location:
  • Phone: 740-326-6110
  • Fax:
Mailing address:
  • Phone: 937-269-4681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE2404963
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: