Healthcare Provider Details

I. General information

NPI: 1881413805
Provider Name (Legal Business Name): KATIE HUNTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2024
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

299 EDWARDS ST
YOUNGSTOWN OH
44502-1599
US

IV. Provider business mailing address

299 EDWARDS ST
YOUNGSTOWN OH
44502-1599
US

V. Phone/Fax

Practice location:
  • Phone: 330-719-6289
  • Fax:
Mailing address:
  • Phone: 330-719-6289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP.16557
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: