Provider Demographics
NPI:1326451808
Name:HUNT, LISA KAREN
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:KAREN
Last Name:HUNT
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 1:135 WOODLAND HLS
Mailing Address - Street 2:
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-9055
Mailing Address - Country:US
Mailing Address - Phone:606-889-8383
Mailing Address - Fax:
Practice Address - Street 1:135 WOODLAND HLS
Practice Address - Street 2:
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-9055
Practice Address - Country:US
Practice Address - Phone:606-889-8383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-03
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY222Q00000XOtherDEVELOPMENTAL INTERVENTIONISTS