Provider Demographics
NPI:1578891339
Name:HUNT, VICKI (M ED, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:VICKI
Middle Name:
Last Name:HUNT
Suffix:
Gender:F
Credentials:M ED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4029 N SHANNON AVE
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:OK
Mailing Address - Zip Code:73008-3062
Mailing Address - Country:US
Mailing Address - Phone:405-255-6714
Mailing Address - Fax:
Practice Address - Street 1:4029 N SHANNON AVE
Practice Address - Street 2:
Practice Address - City:BETHANY
Practice Address - State:OK
Practice Address - Zip Code:73008-3062
Practice Address - Country:US
Practice Address - Phone:405-255-6714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-04
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK979235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist