Provider Demographics
NPI:1356960520
Name:TUNICK, RONI
Entity type:Individual
Prefix:
First Name:RONI
Middle Name:
Last Name:TUNICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RONI
Other - Middle Name:
Other - Last Name:YUTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SLP
Mailing Address - Street 1:1432 CAMDEN AVE APT 104
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-3471
Mailing Address - Country:US
Mailing Address - Phone:310-993-3106
Mailing Address - Fax:
Practice Address - Street 1:1432 CAMDEN AVE APT 104
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-3471
Practice Address - Country:US
Practice Address - Phone:310-993-3106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-08
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
CA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist