Provider Demographics
NPI:1447591235
Name:HUNTER, O'TILIA V (LCPC)
Entity Type:Individual
Prefix:
First Name:O'TILIA
Middle Name:V
Last Name:HUNTER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1606 FAIRLAKES PL
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-3103
Mailing Address - Country:US
Mailing Address - Phone:301-324-3895
Mailing Address - Fax:
Practice Address - Street 1:1606 FAIRLAKES PL
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-3103
Practice Address - Country:US
Practice Address - Phone:301-324-3895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-05
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC4927101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional