Provider Demographics
NPI:1477601037
Name:HUNT, TREVA A (EDS)
Entity Type:Individual
Prefix:MS
First Name:TREVA
Middle Name:A
Last Name:HUNT
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17865 W GELDING DR
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85388-7533
Mailing Address - Country:US
Mailing Address - Phone:602-565-3292
Mailing Address - Fax:623-584-9068
Practice Address - Street 1:17865 W GELDING DR
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85388-7533
Practice Address - Country:US
Practice Address - Phone:602-565-3292
Practice Address - Fax:623-584-9068
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool