Provider Demographics
NPI:1205146131
Name:WUNSCH, AIMEE
Entity type:Individual
Prefix:MRS
First Name:AIMEE
Middle Name:
Last Name:WUNSCH
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:AIMEE
Other - Middle Name:
Other - Last Name:CORCORAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10424 MULLHACEN PL NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-4990
Mailing Address - Country:US
Mailing Address - Phone:505-934-3999
Mailing Address - Fax:
Practice Address - Street 1:10424 MULLHACEN PL NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-4990
Practice Address - Country:US
Practice Address - Phone:505-934-3999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-13
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC-4825235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist