Provider Demographics
NPI:1679304588
Name:HUNTER, EMILY ROSE (OTR)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ROSE
Last Name:HUNTER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 GRAPEVINE MILLS PKWY UNIT 1927
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-0910
Mailing Address - Country:US
Mailing Address - Phone:208-215-5518
Mailing Address - Fax:
Practice Address - Street 1:16415 ADDISON RD STE 150
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-5331
Practice Address - Country:US
Practice Address - Phone:208-215-5518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX124471225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics