Provider Demographics
NPI:1164624532
Name:HUNT, SHELLY LYNN (SLP)
Entity Type:Individual
Prefix:MRS
First Name:SHELLY
Middle Name:LYNN
Last Name:HUNT
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1060 E 86TH ST STE 65C
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-1831
Mailing Address - Country:US
Mailing Address - Phone:217-474-0981
Mailing Address - Fax:317-566-8270
Practice Address - Street 1:1060 E 86TH ST STE 65C
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-1831
Practice Address - Country:US
Practice Address - Phone:217-474-0981
Practice Address - Fax:317-566-8270
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22004484A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist