MEDICARE: MS. CYNTHIA ANN HUNT LCSW

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
1	1041C0700X	Clinical Social Worker	1387173501	UT

General Provider Information

NPI Number	:	1851432553
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CYNTHIA ANN HUNT LCSW

Provider Business Mailing Address
First Line	:	171 EAST 3RD AVE
Second Line	:	#707
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84103-5006
Country	:	US
Telephone Number	:	801-355-5888
Fax Number	:	801-298-2147

Provider Business Practice Location Address
First Line	:	171 EAST 3RD AVE
Second Line	:	#707
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84103-5006
Country	:	US
Telephone Number	:	801-355-5888
Fax Number	:	801-298-2147

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	03/06/2008

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