Provider Demographics
NPI:1285712588
Name:HUNTER, HEATHER DAVIS (LPC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:DAVIS
Last Name:HUNTER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1026 WARWICK PL
Mailing Address - Street 2:
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38671-9412
Mailing Address - Country:US
Mailing Address - Phone:662-536-4591
Mailing Address - Fax:
Practice Address - Street 1:413 W TYLER AVE
Practice Address - Street 2:
Practice Address - City:WEST MEMPHIS
Practice Address - State:AR
Practice Address - Zip Code:72301-4149
Practice Address - Country:US
Practice Address - Phone:870-733-1200
Practice Address - Fax:870-732-3269
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA0110053101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health