Provider Demographics
NPI:1538143417
Name:HUTCHINSON, DONNA G (MSP CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:G
Last Name:HUTCHINSON
Suffix:
Gender:F
Credentials:MSP CCC-SLP
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:G
Other - Last Name:LONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSP CCC-SLP
Mailing Address - Street 1:PO BOX 118
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:SC
Mailing Address - Zip Code:29054-0118
Mailing Address - Country:US
Mailing Address - Phone:803-429-7463
Mailing Address - Fax:803-520-8623
Practice Address - Street 1:524 RIGLAW CIR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29073-7192
Practice Address - Country:US
Practice Address - Phone:803-429-7463
Practice Address - Fax:803-520-8623
Is Sole Proprietor?:No
Enumeration Date:2005-12-03
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3350235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSA0669Medicaid