Healthcare Provider Details

I. General information

NPI: 1629474226
Provider Name (Legal Business Name): GRAHAM A. HUNTER, PHD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2014
Last Update Date: 11/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4425 RANDOLPH RD SUITE 411
CHARLOTTE NC
28211-2351
US

IV. Provider business mailing address

4425 RANDOLPH RD SUITE 411
CHARLOTTE NC
28211-2351
US

V. Phone/Fax

Practice location:
  • Phone: 704-362-5355
  • Fax: 704-362-1170
Mailing address:
  • Phone: 704-362-5355
  • Fax: 704-362-1170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number4178
License Number StateNC

VIII. Authorized Official

Name: DR. GRAHAM A. HUNTER
Title or Position: OWNER/LICENSED PSYCHOLOGIST
Credential: PHD
Phone: 704-362-5355