Provider Demographics
NPI:1477682979
Name:HUNT, MELEESA A (PHD)
Entity Type:Individual
Prefix:
First Name:MELEESA
Middle Name:A
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 1:3070 RIVERSIDE DR
Mailing Address - Street 2:SUITE 150-B
Mailing Address - City:UPPER ARLINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43221-2547
Mailing Address - Country:US
Mailing Address - Phone:614-738-8878
Mailing Address - Fax:
Practice Address - Street 1:3070 RIVERSIDE DR
Practice Address - Street 2:SUITE 150-B
Practice Address - City:UPPER ARLINGTON
Practice Address - State:OH
Practice Address - Zip Code:43221-2547
Practice Address - Country:US
Practice Address - Phone:614-738-8878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2016-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4162103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHHUCP07811Medicare ID - Type UnspecifiedMEDICARE