Provider Demographics
NPI:1215541172
Name:HUNTER, KATHRYN BROOKE
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:BROOKE
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 1:2940 N CHURCH ST STE 303
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84040-6617
Mailing Address - Country:US
Mailing Address - Phone:801-614-2587
Mailing Address - Fax:
Practice Address - Street 1:1600 N 1575 W APT H106
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-5519
Practice Address - Country:US
Practice Address - Phone:336-706-0536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-08
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13305178-2507106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst