Provider Demographics
NPI:1578153490
Name:HUNTER, EBONY S
Entity Type:Individual
Prefix:
First Name:EBONY
Middle Name:S
Last Name:HUNTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 FLINT HILL RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-1914
Mailing Address - Country:US
Mailing Address - Phone:201-344-9664
Mailing Address - Fax:
Practice Address - Street 1:850 LIBRARY AVE STE 104
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-7170
Practice Address - Country:US
Practice Address - Phone:130-272-4666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-25
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE0010313101YP2500X
DEPC-0011258101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional