Provider Demographics
NPI:1790087005
Name:HUNT, REGINA G (MS)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:G
Last Name:HUNT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 ROLLING OAKS DR
Mailing Address - Street 2:
Mailing Address - City:MAUMELLE
Mailing Address - State:AR
Mailing Address - Zip Code:72113-6841
Mailing Address - Country:US
Mailing Address - Phone:501-412-5755
Mailing Address - Fax:501-851-2733
Practice Address - Street 1:700 W 4TH ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72201-2204
Practice Address - Country:US
Practice Address - Phone:501-372-5039
Practice Address - Fax:501-372-5529
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-19
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR84-15E1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist