Provider Demographics
NPI:1376079988
Name:HUNTER, JOHN WESLEY (MS, CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:WESLEY
Last Name:HUNTER
Suffix:
Gender:M
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 1:1754 COMMONWEALTH AVE
Mailing Address - Street 2:APT 3
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-5534
Mailing Address - Country:US
Mailing Address - Phone:215-896-2736
Mailing Address - Fax:
Practice Address - Street 1:1754 COMMONWEALTH AVE
Practice Address - Street 2:APT 3
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02135-5534
Practice Address - Country:US
Practice Address - Phone:215-896-2736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-03
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9673235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist