Provider Demographics
NPI:1831469089
Name:HUNT, DERRICK DEWAYNE (BA)
Entity Type:Individual
Prefix:MR
First Name:DERRICK
Middle Name:DEWAYNE
Last Name:HUNT
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5524 CEDAR ASH CROSSING
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013
Mailing Address - Country:US
Mailing Address - Phone:731-402-1007
Mailing Address - Fax:
Practice Address - Street 1:1921 RANSOM PLACE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217
Practice Address - Country:US
Practice Address - Phone:615-500-0695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-05
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health