Provider Demographics
NPI:1073342663
Name:HUNTER, CARRIE (MT-BC)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:HUNTER
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5675 GOLDEN ISLE W
Mailing Address - Street 2:
Mailing Address - City:BAXLEY
Mailing Address - State:GA
Mailing Address - Zip Code:31513-7982
Mailing Address - Country:US
Mailing Address - Phone:912-278-9077
Mailing Address - Fax:
Practice Address - Street 1:5675 GOLDEN ISLE W
Practice Address - Street 2:
Practice Address - City:BAXLEY
Practice Address - State:GA
Practice Address - Zip Code:31513-7982
Practice Address - Country:US
Practice Address - Phone:912-278-9077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMUT000302225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist