MEDICARE: MRS. DONNA MARIE DURKEE MSW

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	0890000604	VT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710195169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DONNA MARIE DURKEE MSW

Provider Business Mailing Address
First Line	:	977 WALKER MOUNTAIN RD
Second Line	:
City	:	NORTH CLARENDON
State	:	VT
Zip	:	05759-9305
Country	:	US
Telephone Number	:	802-775-5046
Fax Number	:	802-775-5046

Provider Business Practice Location Address
First Line	:	977 WALKER MOUNTAIN RD
Second Line	:
City	:	NORTH CLARENDON
State	:	VT
Zip	:	05759-9305
Country	:	US
Telephone Number	:	802-775-5046
Fax Number	:	802-775-5046

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

Provider Enumeration Date	:	05/18/2007
Last Update Date	:	07/09/2007

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