Provider Demographics
NPI:1962976340
Name:HUNTER, ALAYSHIA MAURICIA-SHAVONNA
Entity type:Individual
Prefix:
First Name:ALAYSHIA
Middle Name:MAURICIA-SHAVONNA
Last Name:HUNTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2825 W FREY ST # 426
Mailing Address - Street 2:
Mailing Address - City:STEPHENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76401-1919
Mailing Address - Country:US
Mailing Address - Phone:254-813-8718
Mailing Address - Fax:
Practice Address - Street 1:2825 W FREY ST # 426
Practice Address - Street 2:
Practice Address - City:STEPHENVILLE
Practice Address - State:TX
Practice Address - Zip Code:76401-1919
Practice Address - Country:US
Practice Address - Phone:254-813-8718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-18
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer