Healthcare Provider Details

I. General information

NPI: 1538885660
Provider Name (Legal Business Name): DONNA HURST PH.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2022
Last Update Date: 10/19/2022
Certification Date: 10/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N CENTER DR STE 100
NORFOLK VA
23502-0002
US

IV. Provider business mailing address

2202 EXECUTIVE DR STE C
HAMPTON VA
23666-6604
US

V. Phone/Fax

Practice location:
  • Phone: 757-965-5886
  • Fax: 757-333-4939
Mailing address:
  • Phone: 757-827-7707
  • Fax: 757-838-2573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701011892
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: