Provider Demographics
NPI:1023457728
Name:HUNGERFORD, MICHELLE (AUD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:HUNGERFORD
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10340 HORSEBACK RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89144-6867
Mailing Address - Country:US
Mailing Address - Phone:614-743-0337
Mailing Address - Fax:
Practice Address - Street 1:9080 W CHEYENNE AVE
Practice Address - Street 2:SUITE 150
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-8936
Practice Address - Country:US
Practice Address - Phone:702-880-1514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-17
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVA-1593231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist