Provider Demographics
NPI:1699754580
Name:HUNTER, SALLY S (MSW LISW)
Entity type:Individual
Prefix:
First Name:SALLY
Middle Name:S
Last Name:HUNTER
Suffix:
Gender:F
Credentials:MSW LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3454 OAK ALLEY CT
Mailing Address - Street 2:STE 410
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-1355
Mailing Address - Country:US
Mailing Address - Phone:419-578-6895
Mailing Address - Fax:419-472-3524
Practice Address - Street 1:3454 OAK ALLEY CT
Practice Address - Street 2:STE 410
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-1355
Practice Address - Country:US
Practice Address - Phone:419-578-6895
Practice Address - Fax:419-472-3524
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI00004771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHHUSW01901Medicare ID - Type Unspecified