Provider Demographics
NPI:1164014825
Name:BUNGER, ALLISON PAIGE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:PAIGE
Last Name:BUNGER
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 1:2222 WAGON WHEEL DR
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-8011
Mailing Address - Country:US
Mailing Address - Phone:513-290-3027
Mailing Address - Fax:
Practice Address - Street 1:250 N FAIR AVE
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-4222
Practice Address - Country:US
Practice Address - Phone:513-887-5035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-04
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.14244235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist