Provider Demographics
NPI:1013683218
Name:HUNTER, MICHELLE (MED EDUCATION, LBSC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:HUNTER
Suffix:
Gender:F
Credentials:MED EDUCATION, LBSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2650 MEETINGHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:JAMISON
Mailing Address - State:PA
Mailing Address - Zip Code:18929-1156
Mailing Address - Country:US
Mailing Address - Phone:267-495-7120
Mailing Address - Fax:
Practice Address - Street 1:2650 MEETINGHOUSE RD
Practice Address - Street 2:
Practice Address - City:JAMISON
Practice Address - State:PA
Practice Address - Zip Code:18929-1156
Practice Address - Country:US
Practice Address - Phone:267-495-7120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH004781103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst