Provider Demographics
NPI:1861778532
Name:HUNT, NICOLE DESIREA (MS, TSSLD)
Entity type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:DESIREA
Last Name:HUNT
Suffix:
Gender:F
Credentials:MS, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 COLGATE AVE
Mailing Address - Street 2:APT 10B
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10473-4861
Mailing Address - Country:US
Mailing Address - Phone:718-542-9918
Mailing Address - Fax:
Practice Address - Street 1:511 HEMPSTEAD AVE
Practice Address - Street 2:
Practice Address - City:WEST HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552-2737
Practice Address - Country:US
Practice Address - Phone:516-565-0388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021261235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist