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General NPI Number Information
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NPI Number | 1669618625
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Entity Type | Individual
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Provider Name | KAYLEIGH HUNNICUTT PH.D.
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Gender | Female
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Dates
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Enumeration Date | 12/22/2008
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Last Update Date | 09/02/2022
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Provider Practice Location Address
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Address Line | 4625 MORSE RD STE 200
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City | GAHANNA
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State | OH
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Zip | 43230-8355
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Country | US
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Telephone | 614-383-8381
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Fax | 855-259-2615
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Provider Business Mailing Address
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Address Line | 264 S PACIFIC AVE
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City | VENTURA
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State | CA
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Zip | 93001-3474
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Country | US
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Telephone | 419-870-0560
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | P.08367
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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