Provider Demographics
NPI:1184820649
Name:GINN, DONNA T (D MIN)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:T
Last Name:GINN
Suffix:
Gender:F
Credentials:D MIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 1 BOX 1932
Mailing Address - Street 2:
Mailing Address - City:TOWNSEND
Mailing Address - State:GA
Mailing Address - Zip Code:31331-9784
Mailing Address - Country:US
Mailing Address - Phone:912-437-2083
Mailing Address - Fax:912-437-3375
Practice Address - Street 1:112 SCOTT AVE
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:GA
Practice Address - Zip Code:31305-9733
Practice Address - Country:US
Practice Address - Phone:912-437-2083
Practice Address - Fax:912-437-3375
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA02063556106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist