Provider Demographics
NPI:1336282292
Name:HUNTER, BERNADETTE M (MS)
Entity Type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:M
Last Name:HUNTER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 OVERLOOK WAY
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59803-2233
Mailing Address - Country:US
Mailing Address - Phone:406-721-8643
Mailing Address - Fax:
Practice Address - Street 1:614 OVERLOOK WAY
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59803-2233
Practice Address - Country:US
Practice Address - Phone:406-721-8643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT432101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional