Provider Demographics
NPI:1033546171
Name:HUNTER, KIA MICHELE (M S)
Entity Type:Individual
Prefix:MS
First Name:KIA
Middle Name:MICHELE
Last Name:HUNTER
Suffix:
Gender:F
Credentials:M S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 GLENDALE RD
Mailing Address - Street 2:
Mailing Address - City:UPPER DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19082-5018
Mailing Address - Country:US
Mailing Address - Phone:215-900-0891
Mailing Address - Fax:
Practice Address - Street 1:519 GLENDALE RD
Practice Address - Street 2:
Practice Address - City:UPPER DARBY
Practice Address - State:PA
Practice Address - Zip Code:19082-5018
Practice Address - Country:US
Practice Address - Phone:215-900-0891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH000321101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional