Provider Demographics
NPI:1932264686
Name:HUNTING, MARY DALLIN (CCC-A)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:DALLIN
Last Name:HUNTING
Suffix:
Gender:F
Credentials:CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 NEW ROCHESTER RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-8800
Mailing Address - Country:US
Mailing Address - Phone:603-742-6555
Mailing Address - Fax:603-742-2908
Practice Address - Street 1:113 NEW ROCHESTER RD
Practice Address - Street 2:SUITE 2
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-8800
Practice Address - Country:US
Practice Address - Phone:603-742-6555
Practice Address - Fax:603-742-2908
Is Sole Proprietor?:No
Enumeration Date:2006-12-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHA482231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30432497Medicaid
NH1010206000OtherDEPARTMENT OF LABOR
NVAA40159OtherHARVARD PILGRIM
NHP95779Medicare UPIN
NHHU038964Medicare ID - Type Unspecified