Healthcare Provider Details

I. General information

NPI: 1548349798
Provider Name (Legal Business Name): KEVIN HUBAN PSY.D., D,ABSM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WYOMING ST SLEEP CENTER, MIAMI VALLEY HOSPITAL
DAYTON OH
45409-2722
US

IV. Provider business mailing address

235 GREENMOUNT BLVD
DAYTON OH
45419-3243
US

V. Phone/Fax

Practice location:
  • Phone: 937-208-2515
  • Fax:
Mailing address:
  • Phone: 937-299-2924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number3608
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3608
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number3608
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: