Provider Demographics
NPI:1982054771
Name:HUNTER, KIERSTEN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KIERSTEN
Middle Name:
Last Name:HUNTER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:KIERSTEN
Other - Middle Name:
Other - Last Name:SCIFRES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:3000 S STATE ROAD 135
Mailing Address - Street 2:SUITE 110
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-9825
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3000 S STATE ROAD 135
Practice Address - Street 2:SUITE 110
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-9825
Practice Address - Country:US
Practice Address - Phone:317-535-4075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-13
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22006204A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist