Provider Demographics
NPI:1033328992
Name:HUNT, STANA (MAED)
Entity Type:Individual
Prefix:MRS
First Name:STANA
Middle Name:
Last Name:HUNT
Suffix:
Gender:F
Credentials:MAED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 N SAGUARO ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-4282
Mailing Address - Country:US
Mailing Address - Phone:602-740-4623
Mailing Address - Fax:
Practice Address - Street 1:29697 N DESERT WILLOW BLVD
Practice Address - Street 2:WALKER BUTTE K-8 SCHOOL
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85243-3917
Practice Address - Country:US
Practice Address - Phone:480-987-5360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ974130Medicaid