Provider Demographics
NPI:1962044859
Name:HUNSICKER, DEBORAH JANE I
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:JANE
Last Name:HUNSICKER
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 TERRACE LN
Mailing Address - Street 2:
Mailing Address - City:IVORYTON
Mailing Address - State:CT
Mailing Address - Zip Code:06442-1219
Mailing Address - Country:US
Mailing Address - Phone:860-767-7385
Mailing Address - Fax:
Practice Address - Street 1:4 TERRACE LN
Practice Address - Street 2:
Practice Address - City:IVORYTON
Practice Address - State:CT
Practice Address - Zip Code:06442-1219
Practice Address - Country:US
Practice Address - Phone:860-767-7385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-11
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001785235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist