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NPI Code Detail

MEDICARE: MRS. MIRANDA MIZE HUNT MS, CCC-SLP

MEDICARE:  MRS. MIRANDA MIZE HUNT  MS, CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist142428KY

General Provider Information

NPI Number : 1043477698
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MIRANDA MIZE HUNT MS, CCC-SLP
Provider Business Mailing Address
First Line : 411 FONSO CIR
Second Line :
City : BOWLING GREEN
State : KY
Zip : 42104-5582
Country : US
Telephone Number : 606-219-0231
Fax Number :
Provider Business Practice Location Address
First Line : 5079 SCOTTSVILLE RD
Second Line :
City : BOWLING GREEN
State : KY
Zip : 42104-7897
Country : US
Telephone Number : 270-781-2462
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2008
Last Update Date : 06/10/2020

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Directions to “ MRS. MIRANDA MIZE HUNT MS, CCC-SLP” Practice Location

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