Provider Demographics
NPI:1356571889
Name:HUNT, CAROLYN MARY
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:MARY
Last Name:HUNT
Suffix:
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 1:28 BRAINARD AVE
Mailing Address - Street 2:#303
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-5123
Mailing Address - Country:US
Mailing Address - Phone:508-527-4614
Mailing Address - Fax:
Practice Address - Street 1:9 LACRUE AVENUE
Practice Address - Street 2:SUITE #210
Practice Address - City:CONCORDVILLE
Practice Address - State:PA
Practice Address - Zip Code:19331-1111
Practice Address - Country:US
Practice Address - Phone:800-578-7906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-17
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7506235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist