Provider Demographics
NPI:1003691650
Name:HUNTER, JESSICA DENISE
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:DENISE
Last Name:HUNTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28116 ORCHARD LAKE RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3713
Mailing Address - Country:US
Mailing Address - Phone:248-550-0333
Mailing Address - Fax:
Practice Address - Street 1:28116 ORCHARD LAKE RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3713
Practice Address - Country:US
Practice Address - Phone:248-550-0333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician