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General NPI Number Information
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NPI Number | 1851666911
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Entity Type | Organization
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Legal Business Name | HUNTER PSYCHOTHERAPY SERVICES, LLC
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Dates
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Enumeration Date | 03/21/2012
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Last Update Date | 03/21/2012
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Provider Practice Location Address
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Address Line | 437 S YELLOWSTONE DR SUITE 209
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City | MADISON
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State | WI
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Zip | 53719-2902
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Country | US
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Telephone | 608-219-9561
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Fax | 608-630-8210
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Provider Business Mailing Address
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Address Line | 437 S YELLOWSTONE DR SUITE 209
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City | MADISON
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State | WI
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Zip | 53719-2902
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Country | US
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Telephone | 608-219-9561
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Fax | 608-630-8210
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | ELLYN HUNTER
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Credential | LMFT
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Telephone | 608-219-9561
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 419-124
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License Number State | WI
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