Provider Demographics
NPI:1366478422
Name:WILLETT, DONNA (LMFT)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:WILLETT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 HUDGINS RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-4172
Mailing Address - Country:US
Mailing Address - Phone:540-891-0817
Mailing Address - Fax:540-786-1705
Practice Address - Street 1:420 HUDGINS RD
Practice Address - Street 2:SUITE 201
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-4172
Practice Address - Country:US
Practice Address - Phone:540-891-0817
Practice Address - Fax:540-786-1705
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0717000644106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist