Provider Demographics
NPI:1235441403
Name:HUNT, MONICA MONIQUE (MS,RD,LD)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:MONIQUE
Last Name:HUNT
Suffix:
Gender:F
Credentials:MS,RD,LD
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:MONIQUE
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2500 HIGHWAY 65 S
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:AR
Mailing Address - Zip Code:72031-6588
Mailing Address - Country:US
Mailing Address - Phone:501-745-9567
Mailing Address - Fax:501-745-9445
Practice Address - Street 1:2500 HIGHWAY 65 S
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:AR
Practice Address - Zip Code:72031-6588
Practice Address - Country:US
Practice Address - Phone:501-745-9567
Practice Address - Fax:501-745-9445
Is Sole Proprietor?:No
Enumeration Date:2010-07-05
Last Update Date:2010-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1051133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered