Provider Demographics
NPI:1962416198
Name:HUNT, DONALD J (MED)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:J
Last Name:HUNT
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1482 GOSS HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:ST JOHNSBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05819-9142
Mailing Address - Country:US
Mailing Address - Phone:802-748-0985
Mailing Address - Fax:802-626-3945
Practice Address - Street 1:1482 GOSS HOLLOW RD
Practice Address - Street 2:
Practice Address - City:ST JOHNSBURY
Practice Address - State:VT
Practice Address - Zip Code:05819-9142
Practice Address - Country:US
Practice Address - Phone:802-748-0985
Practice Address - Fax:802-626-3945
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT047-0000593103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1005528Medicaid