Provider Demographics
NPI:1396187332
Name:SUNDBOOM, HILARY
Entity Type:Individual
Prefix:
First Name:HILARY
Middle Name:
Last Name:SUNDBOOM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HILARY
Other - Middle Name:
Other - Last Name:BERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:331 W 33RD AVE
Mailing Address - Street 2:APT 8
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-4706
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:161 KLEVIN ST
Practice Address - Street 2:SUITE 103
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-1508
Practice Address - Country:US
Practice Address - Phone:907-561-8060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-18
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist