Provider Demographics
NPI:1275601783
Name:HUNT, PORTIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:PORTIA
Middle Name:
Last Name:HUNT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 E SEDGWICK ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-1329
Mailing Address - Country:US
Mailing Address - Phone:215-248-2917
Mailing Address - Fax:215-248-5777
Practice Address - Street 1:1616 WALNUT ST
Practice Address - Street 2:2115
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-5313
Practice Address - Country:US
Practice Address - Phone:215-985-4451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS003296L103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPS003296LOtherPSYCHOLOGIST