Provider Demographics
NPI:1174935993
Name:MARCONI-HUTKAY, KIRSTEN (AUD)
Entity type:Individual
Prefix:DR
First Name:KIRSTEN
Middle Name:
Last Name:MARCONI-HUTKAY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6057 STRIP AVE NW
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-9207
Mailing Address - Country:US
Mailing Address - Phone:330-492-8136
Mailing Address - Fax:
Practice Address - Street 1:2100 38TH ST NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44709
Practice Address - Country:US
Practice Address - Phone:330-492-8136
Practice Address - Fax:330-493-9130
Is Sole Proprietor?:No
Enumeration Date:2014-05-28
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA01588231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist