Basic Information
Provider Information
NPI: 1497073548
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUNTER
FirstName: CHERYL
MiddleName: LYNN
NamePrefix: MS.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1211 N SHARTEL AVE
Address2:  
City: OKLAHOMA CITY
State: OK
PostalCode: 731032400
CountryCode: US
TelephoneNumber: 4059221841
FaxNumber: 4055218652
Practice Location
Address1: 1211 N SHARTEL AVE
Address2:  
City: OKLAHOMA CITY
State: OK
PostalCode: 731032400
CountryCode: US
TelephoneNumber: 4059221841
FaxNumber: 4055218652
Other Information
ProviderEnumerationDate: 05/13/2010
LastUpdateDate: 05/13/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103K00000X OKY Behavioral Health & Social Service ProvidersBehavioral Analyst 

No ID Information.


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