MEDICARE: MRS. JACQUELINE ACRITELLI-HUNT M.S., 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
1	235Z00000X	Speech-Language Pathologist	7560	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12074665	OTHER		ASHA CERTIFICATION NUMBER

General Provider Information

NPI Number	:	1417158486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JACQUELINE ACRITELLI-HUNT M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	1260 BROUGH HALL DRIVE
Second Line	:
City	:	WAXHAW
State	:	NC
Zip	:	28173-6937
Country	:	US
Telephone Number	:	516-848-0993
Fax Number	:

Provider Business Practice Location Address
First Line	:	598 INDIAN TRAIL RD S # 141
Second Line	:
City	:	INDIAN TRAIL
State	:	NC
Zip	:	28079-8689
Country	:	US
Telephone Number	:	704-975-7008
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2007
Last Update Date	:	07/08/2007

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Directions to “ MRS. JACQUELINE ACRITELLI-HUNT M.S., CCC-SLP” Practice Location

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