Provider Demographics
NPI:1518564889
Name:HUNGERFORD, KRISTIN NOEL (SPEECH-LANGUAGE PATH)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:NOEL
Last Name:HUNGERFORD
Suffix:
Gender:F
Credentials:SPEECH-LANGUAGE PATH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5103 W PIERSON RD STE 3
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48504-1395
Mailing Address - Country:US
Mailing Address - Phone:810-391-2923
Mailing Address - Fax:210-391-2968
Practice Address - Street 1:5103 W PIERSON RD STE 3
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48504-1395
Practice Address - Country:US
Practice Address - Phone:810-391-2923
Practice Address - Fax:210-391-2968
Is Sole Proprietor?:No
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101002580225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist