Provider Demographics
NPI:1275308017
Name:HUNTER, MYCHAL
Entity type:Individual
Prefix:MRS
First Name:MYCHAL
Middle Name:
Last Name:HUNTER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4555 E SAHARA AVE UNIT 237
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-6372
Mailing Address - Country:US
Mailing Address - Phone:702-417-9587
Mailing Address - Fax:
Practice Address - Street 1:4555 E SAHARA AVE UNIT 237
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-6372
Practice Address - Country:US
Practice Address - Phone:702-417-9587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-21
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator