Provider Demographics
NPI:1609836105
Name:HUNT, TERESA M (PHD)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:M
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 1:1438 RIDGEWAY E
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MD
Mailing Address - Zip Code:21012-2423
Mailing Address - Country:US
Mailing Address - Phone:410-507-5650
Mailing Address - Fax:
Practice Address - Street 1:133 DEFENSE HWY
Practice Address - Street 2:SUITE #210
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7098
Practice Address - Country:US
Practice Address - Phone:410-507-5650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-27
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03975103TC0700X
MI6301006723103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical