Provider Demographics
NPI:1528765856
Name:HUNTER, DANA MARIE (BA)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:MARIE
Last Name:HUNTER
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 HIDDEN HOLLOW CT
Mailing Address - Street 2:
Mailing Address - City:DENMARK
Mailing Address - State:WI
Mailing Address - Zip Code:54208-8317
Mailing Address - Country:US
Mailing Address - Phone:920-217-3339
Mailing Address - Fax:
Practice Address - Street 1:411 HIDDEN HOLLOW CT
Practice Address - Street 2:
Practice Address - City:DENMARK
Practice Address - State:WI
Practice Address - Zip Code:54208-8317
Practice Address - Country:US
Practice Address - Phone:920-217-3339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100052193Medicaid