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General NPI Number Information
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NPI Number | 1881883254
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Entity Type | Individual
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Provider Name | CAROLYN SUE HUNTSMAN ME.D.
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Gender | Female
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Dates
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Enumeration Date | 10/22/2007
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Last Update Date | 10/22/2007
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Provider Practice Location Address
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Address Line | 7921 E SAN MIGUEL AVE #5
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City | SCOTTSDALE
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State | AZ
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Zip | 85250-6558
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Country | US
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Telephone | 480-219-5633
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Fax | 602-595-9911
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Provider Business Mailing Address
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Address Line | 1536 EAST MARYLAND AVE SUITE B104
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City | PHOENIX
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State | AZ
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Zip | 85014-1469
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Country | US
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Telephone | 480-201-3113
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Fax | 602-595-9911
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC #11741
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License Number State | AZ
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