Provider Demographics
NPI:1881311678
Name:HUNT, LOLA MARIA
Entity type:Individual
Prefix:
First Name:LOLA
Middle Name:MARIA
Last Name:HUNT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LOLA
Other - Middle Name:MARIA
Other - Last Name:BUENO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3008 SUDBURY DR
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45420-1129
Mailing Address - Country:US
Mailing Address - Phone:937-310-1269
Mailing Address - Fax:937-310-1199
Practice Address - Street 1:3008 SUDBURY DR
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45420-1129
Practice Address - Country:US
Practice Address - Phone:937-310-1269
Practice Address - Fax:937-310-1199
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)