Provider Demographics
NPI:1528843893
Name:HUNDLEY, MARSHA (SLP MED CCC)
Entity type:Individual
Prefix:
First Name:MARSHA
Middle Name:
Last Name:HUNDLEY
Suffix:
Gender:F
Credentials:SLP MED CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 762
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:UT
Mailing Address - Zip Code:84701-0762
Mailing Address - Country:US
Mailing Address - Phone:435-979-4752
Mailing Address - Fax:
Practice Address - Street 1:65 N 400 W
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:UT
Practice Address - Zip Code:84620-7613
Practice Address - Country:US
Practice Address - Phone:435-979-4752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-25
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5533682-4102235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist