Provider Demographics
NPI:1508624958
Name:HUNSICKER, STACY KRISTINE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:KRISTINE
Last Name:HUNSICKER
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 1:2828 HUDSON AURORA RD
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-2420
Mailing Address - Country:US
Mailing Address - Phone:717-314-3931
Mailing Address - Fax:
Practice Address - Street 1:30 ROTHROCK LOOP
Practice Address - Street 2:
Practice Address - City:COPLEY
Practice Address - State:OH
Practice Address - Zip Code:44321-1331
Practice Address - Country:US
Practice Address - Phone:330-441-1241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist