Basic Information
| Provider Information | |||||||||
| NPI: | 1962545517 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HUNT | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | K. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2957 | ||||||||
| Address2: | 445 CAMINO DEL REY, SUITE B | ||||||||
| City: | LOS LUNAS | ||||||||
| State: | NM | ||||||||
| PostalCode: | 870312957 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052220831 | ||||||||
| FaxNumber: | 5052220873 | ||||||||
| Practice Location | |||||||||
| Address1: | 445 CAMINO DEL REY | ||||||||
| Address2: | SUITE B | ||||||||
| City: | LOS LUNAS | ||||||||
| State: | NM | ||||||||
| PostalCode: | 870318648 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052220831 | ||||||||
| FaxNumber: | 5052220873 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2007 | ||||||||
| LastUpdateDate: | 10/04/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TP0016X | 1051 | NM | Y | Behavioral Health & Social Service Providers | Psychologist | Prescribing (Medical) | 103TF0200X | 1051 | NM | N | Behavioral Health & Social Service Providers | Psychologist | Forensic | 103G00000X | 1051 | NM | N | Behavioral Health & Social Service Providers | Clinical Neuropsychologist | 103G00000X | 15463 | CA | N | Behavioral Health & Social Service Providers | Clinical Neuropsychologist |
No ID Information.