Provider Demographics
NPI:1285127522
Name:CHESTER, DONNA M
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:M
Last Name:CHESTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 W 200 N
Mailing Address - Street 2:
Mailing Address - City:MIDWAY
Mailing Address - State:UT
Mailing Address - Zip Code:84049-6348
Mailing Address - Country:US
Mailing Address - Phone:435-503-5215
Mailing Address - Fax:
Practice Address - Street 1:45 WEST 700 SOUTH
Practice Address - Street 2:
Practice Address - City:EPHRAIM
Practice Address - State:UT
Practice Address - Zip Code:84627
Practice Address - Country:US
Practice Address - Phone:435-283-4690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-12
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health