Provider Demographics
NPI:1205277357
Name:HUNT, DEIDRE DEVETTE
Entity type:Individual
Prefix:MRS
First Name:DEIDRE
Middle Name:DEVETTE
Last Name:HUNT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4699 LEONARDTOWN RD
Mailing Address - Street 2:UNIT B
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20601-4625
Mailing Address - Country:US
Mailing Address - Phone:301-350-5274
Mailing Address - Fax:
Practice Address - Street 1:4699 LEONARDTOWN RD
Practice Address - Street 2:UNIT B
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20601-4625
Practice Address - Country:US
Practice Address - Phone:301-350-5274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-17
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst