Basic Information
| Provider Information | |||||||||
| NPI: | 1578969945 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCCUNE | ||||||||
| FirstName: | ANNIE | ||||||||
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| Credential: | AU.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 215 SHUMAN BLVD | ||||||||
| Address2: | STE 401 | ||||||||
| City: | NAPERVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605638458 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6303035380 | ||||||||
| FaxNumber: | 9783136824 | ||||||||
| Practice Location | |||||||||
| Address1: | 9525 KENWOOD RD | ||||||||
| Address2: | STE 11 | ||||||||
| City: | BLUE ASH | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452426176 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5137910728 | ||||||||
| FaxNumber: | 5137854023 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/13/2014 | ||||||||
| LastUpdateDate: | 11/13/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237600000X | A. 01900 | OH | Y | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter | 237700000X | 03237 | OH | N | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |
No ID Information.