MEDICARE: DONNA HURST PH.D

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	101YP2500X	Professional Counselor	0701011892	VA

General Provider Information

NPI Number	:	1538885660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA HURST PH.D

Provider Business Mailing Address
First Line	:	2202 EXECUTIVE DR STE C
Second Line	:
City	:	HAMPTON
State	:	VA
Zip	:	23666-6604
Country	:	US
Telephone Number	:	757-827-7707
Fax Number	:	757-838-2573

Provider Business Practice Location Address
First Line	:	400 N CENTER DR STE 100
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23502-0002
Country	:	US
Telephone Number	:	757-965-5886
Fax Number	:	757-333-4939

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

Provider Enumeration Date	:	10/19/2022
Last Update Date	:	10/19/2022

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Directions to “ DONNA HURST PH.D” Practice Location

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