Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 071-003169 | IL |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 071-003169 | IL |
Y | 103G00000X | Clinical Psychologist | 071-003169 | IL |
Y | 103TC0700X | Clinical Psychologist | 071-003169 | IL |
N | 103TF0200X | Forensic Psychologist | 071-003169 | IL |
N | 103TM1800X | Intellectual & Developmental Disabilities | 071-003169 | IL |
NPI | 1548284748 |
---|---|
Provider Name | Dr. Richard H. Hunter |
First Address | Marion, IL 62959-5844 |
Second Address | Marion, IL 62959-5844 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 14/02/2014 |