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NPI Code Detail

MEDICARE: SARA MAE HUNT PHD

MEDICARE: SARA MAE HUNT PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist0686NV

General Provider Information

NPI Number : 1578894432
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARA MAE HUNT PHD
Provider Business Mailing Address
First Line : 1409 E LAKE MEAD BLVD
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89030-7120
Country : US
Telephone Number : 702-657-5578
Fax Number :
Provider Business Practice Location Address
First Line : 1409 E LAKE MEAD BLVD
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89030-7120
Country : US
Telephone Number : 702-657-5578
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2010
Last Update Date : 09/15/2014

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Directions to “ SARA MAE HUNT PHD” Practice Location

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