Provider Demographics
NPI:1184830903
Name:HUNT, ANASTASIA CONSTANCE (SLP)
Entity type:Individual
Prefix:MS
First Name:ANASTASIA
Middle Name:CONSTANCE
Last Name:HUNT
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MS
Other - First Name:ANASTASIA
Other - Middle Name:CONSTANCE
Other - Last Name:HUNT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SLP
Mailing Address - Street 1:6701 LONGLAKE DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202
Mailing Address - Country:US
Mailing Address - Phone:502-589-8915
Mailing Address - Fax:
Practice Address - Street 1:3400 WALNUT STREET
Practice Address - Street 2:A.HUNT, SLP / WINDSONG VILLAGE
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581
Practice Address - Country:US
Practice Address - Phone:281-485-2776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI821-154261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42706500Medicaid