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Individual

CONNIE MARIE HUNT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D., DAC

Contact information

Practice address
4212 N 16TH ST, PHOENIX, AZ 85016-5319
(602) 263-1200
(602) 263-1631
Mailing address
PO BOX 31001-0698, PASADENA, CA 91110-0001
(602) 263-1200
(602) 263-1631

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1116
OR
103TA0400X
Addiction (Substance Use Disorder) Psychologist
4622

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
273855
OR
Enumeration date
07/05/2007
Last updated
05/14/2008
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