Provider Demographics
NPI:1821143306
Name:HUNT, DIANE S (MCAT)
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:S
Last Name:HUNT
Suffix:
Gender:F
Credentials:MCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 MIDVALE AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19129-1027
Mailing Address - Country:US
Mailing Address - Phone:215-991-6703
Mailing Address - Fax:215-991-9098
Practice Address - Street 1:2401 PENNSYLVANIA AVE.
Practice Address - Street 2:SUITE 1C-51
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19130-7723
Practice Address - Country:US
Practice Address - Phone:215-232-0179
Practice Address - Fax:215-991-9098
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC000658101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional