Provider Demographics
NPI:1508999038
Name:HUNTER, CLEO AILEEN (MFT)
Entity Type:Individual
Prefix:
First Name:CLEO
Middle Name:AILEEN
Last Name:HUNTER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23444 GLENRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91321-3955
Mailing Address - Country:US
Mailing Address - Phone:818-970-0494
Mailing Address - Fax:661-670-0594
Practice Address - Street 1:11565 LAUREL CANYON BLVD
Practice Address - Street 2:#100
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-4168
Practice Address - Country:US
Practice Address - Phone:818-365-4723
Practice Address - Fax:818-365-3475
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6502106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist