Provider Demographics
NPI:1194359927
Name:HUNSINGER, ANDREA SUE (MA; CCC/SLP)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:SUE
Last Name:HUNSINGER
Suffix:
Gender:F
Credentials:MA; CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 27TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33704-2925
Mailing Address - Country:US
Mailing Address - Phone:727-421-0063
Mailing Address - Fax:
Practice Address - Street 1:502 PASADENA AVE S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33707-2126
Practice Address - Country:US
Practice Address - Phone:727-289-1212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-02
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA1695235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL106162800Medicaid