Provider Demographics
NPI:1164615498
Name:NUNN, DANUZA (MS-CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DANUZA
Middle Name:
Last Name:NUNN
Suffix:
Gender:F
Credentials:MS-CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 EMERSON PL
Mailing Address - Street 2:21 A
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2204
Mailing Address - Country:US
Mailing Address - Phone:617-724-7901
Mailing Address - Fax:617-724-0771
Practice Address - Street 1:275 CAMBRIDGE ST
Practice Address - Street 2:POB 3RD FLOOR
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3108
Practice Address - Country:US
Practice Address - Phone:617-724-7901
Practice Address - Fax:617-724-0771
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5800235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist