Provider Demographics
NPI:1619305273
Name:HUNT, RAND GLEN (MS)
Entity Type:Individual
Prefix:MR
First Name:RAND
Middle Name:GLEN
Last Name:HUNT
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 E 2ND ST # 4
Mailing Address - Street 2:
Mailing Address - City:COQUILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97423-1864
Mailing Address - Country:US
Mailing Address - Phone:541-824-0990
Mailing Address - Fax:541-824-0991
Practice Address - Street 1:222 E 2ND ST # 4
Practice Address - Street 2:
Practice Address - City:COQUILLE
Practice Address - State:OR
Practice Address - Zip Code:97423-1864
Practice Address - Country:US
Practice Address - Phone:541-824-0990
Practice Address - Fax:541-824-0991
Is Sole Proprietor?:No
Enumeration Date:2013-10-17
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC6025101YM0800X
TX71440101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional