Provider Demographics
NPI:1760700561
Name:HUNNICUTT, LAUREN SUZANNE (CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:LAUREN
Middle Name:SUZANNE
Last Name:HUNNICUTT
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 CEDAR CROSSING LN
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-6236
Mailing Address - Country:US
Mailing Address - Phone:864-630-1507
Mailing Address - Fax:
Practice Address - Street 1:229 CEDAR CROSSING LN
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-6236
Practice Address - Country:US
Practice Address - Phone:864-630-1507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-04
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4376235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist