Basic Information
Provider Information
NPI: 1164089850
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUNT
FirstName: CLAIRE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MOT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2700 STANLEY GAULT PKWY STE 129
Address2:  
City: LOUISVILLE
State: KY
PostalCode: 402235176
CountryCode: US
TelephoneNumber: 5022534914
FaxNumber: 5024895751
Practice Location
Address1: 115 KIANA CT
Address2:  
City: PADUCAH
State: KY
PostalCode: 420016787
CountryCode: US
TelephoneNumber: 5022534914
FaxNumber: 5024895751
Other Information
ProviderEnumerationDate: 05/29/2019
LastUpdateDate: 12/07/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/07/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X134127KYY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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