Provider Demographics
NPI:1538437363
Name:HUNSPERGER, LISA RENEE
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:RENEE
Last Name:HUNSPERGER
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:LISA
Other - Middle Name:RENEE
Other - Last Name:KLAUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1402 PAULIE RD
Mailing Address - Street 2:
Mailing Address - City:CARTERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62918-2346
Mailing Address - Country:US
Mailing Address - Phone:618-985-9124
Mailing Address - Fax:
Practice Address - Street 1:1402 PAULIE RD
Practice Address - Street 2:
Practice Address - City:CARTERVILLE
Practice Address - State:IL
Practice Address - Zip Code:62918-2346
Practice Address - Country:US
Practice Address - Phone:618-985-9124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-07
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst