Healthcare Provider Details

I. General information

NPI: 1093157547
Provider Name (Legal Business Name): BONNIE JO HUNSICKER M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2013
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 LILAC DR STE 100
EDMOND OK
73034-7297
US

IV. Provider business mailing address

6608 N WESTERN AVE # 1570
OKLAHOMA CITY OK
73116-7326
US

V. Phone/Fax

Practice location:
  • Phone: 405-645-0685
  • Fax: 572-213-1113
Mailing address:
  • Phone: 405-645-0685
  • Fax: 572-213-1113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number4083
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: