Provider Demographics
NPI:1992992101
Name:LJ HUNTER, JEID N
Entity type:Individual
Prefix:MRS
First Name:JEID
Middle Name:N
Last Name:LJ HUNTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TIFFANIE
Other - Middle Name:
Other - Last Name:HUNTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6860 66TH ST N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-5036
Mailing Address - Country:US
Mailing Address - Phone:727-373-6732
Mailing Address - Fax:
Practice Address - Street 1:6860 66TH ST N
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-5036
Practice Address - Country:US
Practice Address - Phone:727-373-6732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-02
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
FLMA93974225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor