Provider Demographics
NPI:1669534715
Name:HUNNICUTT, ANGELA DAWN (PHD, HSPP)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:DAWN
Last Name:HUNNICUTT
Suffix:
Gender:F
Credentials:PHD, HSPP
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:DAWN
Other - Last Name:POWER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9240 N MERIDIAN ST
Mailing Address - Street 2:STE. 320
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-1880
Mailing Address - Country:US
Mailing Address - Phone:317-844-7489
Mailing Address - Fax:317-581-1007
Practice Address - Street 1:9240 N MERIDIAN ST
Practice Address - Street 2:STE. 320
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1880
Practice Address - Country:US
Practice Address - Phone:317-844-7489
Practice Address - Fax:317-581-1007
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20041476A103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist