Provider Demographics
NPI:1053458448
Name:BUNCE, BETTY LOUISE (CCC-SLP)
Entity Type:Individual
Prefix:DR
First Name:BETTY
Middle Name:LOUISE
Last Name:BUNCE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 SUNNYSIDE AVE
Mailing Address - Street 2:2101 HAWORTH HALL
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66045-7534
Mailing Address - Country:US
Mailing Address - Phone:785-864-4690
Mailing Address - Fax:785-864-5094
Practice Address - Street 1:1200 SUNNYSIDE AVE
Practice Address - Street 2:2101 HAWORTH HALL
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66045-7534
Practice Address - Country:US
Practice Address - Phone:785-864-4690
Practice Address - Fax:785-864-5094
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS00123235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS018369OtherBLUE CROSS BLUE SHIELD