MEDICARE: HUBER SPEECH THERAPY

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	252Y00000X	Early Intervention Provider Agency	1690	KY

General Provider Information

NPI Number	:	1255878500
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUBER SPEECH THERAPY

Provider Business Mailing Address
First Line	:	6127 KEY PIKE
Second Line	:
City	:	MAYSVILLE
State	:	KY
Zip	:	41056-8633
Country	:	US
Telephone Number	:	606-301-3768
Fax Number	:

Provider Business Practice Location Address
First Line	:	6127 KEY PIKE
Second Line	:
City	:	MAYSVILLE
State	:	KY
Zip	:	41056-8633
Country	:	US
Telephone Number	:	606-301-3768
Fax Number	:

Authorized Official
Title or Position	:	SPEECH-LANGUAGE PATHOLOGIST
Name	:	HOLLY ERIN HUBER
Credential	:	M.A. CCC/SLP
Telephone Number	:	606-301-3768

Provider Enumeration Date	:	01/25/2017
Last Update Date	:	01/25/2017

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Directions to “HUBER SPEECH THERAPY ” Practice Location

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