Provider Demographics
NPI:1689963886
Name:HUNTER, JUDY FAYE (MAC, LAC)
Entity Type:Individual
Prefix:MS
First Name:JUDY
Middle Name:FAYE
Last Name:HUNTER
Suffix:
Gender:F
Credentials:MAC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14751 PURCELLVILLE RD
Mailing Address - Street 2:
Mailing Address - City:PURCELLVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20132-3601
Mailing Address - Country:US
Mailing Address - Phone:571-291-5420
Mailing Address - Fax:
Practice Address - Street 1:170 W MAIN ST
Practice Address - Street 2:
Practice Address - City:PURCELLVILLE
Practice Address - State:VA
Practice Address - Zip Code:20132-3023
Practice Address - Country:US
Practice Address - Phone:571-291-5420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-29
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121000536171100000X
MDU01598171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist