Provider Demographics
NPI:1104039478
Name:HILL, DONNA JO (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:JO
Last Name:HILL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1507 S 2100 E
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84108-2722
Mailing Address - Country:US
Mailing Address - Phone:801-583-3057
Mailing Address - Fax:801-583-3057
Practice Address - Street 1:1507 S 2100 E
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84108-2722
Practice Address - Country:US
Practice Address - Phone:801-583-3057
Practice Address - Fax:801-583-3057
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT136556-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical