Healthcare Provider Details

I. General information

NPI: 1780961177
Provider Name (Legal Business Name): GRAHAM ALEXANDER HUNTER PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2011
Last Update Date: 03/02/2020
Certification Date: 03/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

447 S SHARON AMITY RD SUITE 140
CHARLOTTE NC
28211-2836
US

IV. Provider business mailing address

447 S SHARON AMITY RD SUITE 140
CHARLOTTE NC
28211-2836
US

V. Phone/Fax

Practice location:
  • Phone: 704-900-9143
  • Fax: 704-364-6267
Mailing address:
  • Phone: 704-900-9143
  • Fax: 704-364-6267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number4178
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: