=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629474226
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GRAHAM A. HUNTER, PHD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/08/2014
-----------------------------------------------------
Last Update Date | 11/08/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4425 RANDOLPH RD SUITE 411
-----------------------------------------------------
City | CHARLOTTE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28211-2351
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-362-5355
-----------------------------------------------------
Fax | 704-362-1170
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4425 RANDOLPH RD SUITE 411
-----------------------------------------------------
City | CHARLOTTE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28211-2351
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-362-5355
-----------------------------------------------------
Fax | 704-362-1170
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/LICENSED PSYCHOLOGIST
-----------------------------------------------------
Name | DR. GRAHAM A. HUNTER
-----------------------------------------------------
Credential | PHD
-----------------------------------------------------
Telephone | 704-362-5355
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103T00000X
-----------------------------------------------------
Taxonomy Name | Psychologist
-----------------------------------------------------
License Number | 4178
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------