Provider Demographics
NPI:1174306997
Name:HUNT, MADELEINE ELIZABETH (OTR/L)
Entity type:Individual
Prefix:
First Name:MADELEINE
Middle Name:ELIZABETH
Last Name:HUNT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 FORAGE DR
Mailing Address - Street 2:
Mailing Address - City:MICKLETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08056-1345
Mailing Address - Country:US
Mailing Address - Phone:570-506-7052
Mailing Address - Fax:
Practice Address - Street 1:500 MARIS GROVE WAY
Practice Address - Street 2:
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-3371
Practice Address - Country:US
Practice Address - Phone:610-947-4327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC019312225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist