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General NPI Number Information
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NPI Number | 1255535373
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Entity Type | Individual
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Provider Name | JULIE LYNN KUBIN MS, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 06/13/2007
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Last Update Date | 03/03/2008
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Provider Practice Location Address
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Address Line | 3002 W 2ND AVE
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City | CORSICANA
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State | TX
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Zip | 75110-2408
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Country | US
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Telephone | 903-641-0545
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Fax |
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Provider Business Mailing Address
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Address Line | 1716 PRESTWICK LN
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City | ENNIS
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State | TX
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Zip | 75119-1195
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Country | US
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Telephone | 972-875-2410
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 103120
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License Number State | TX
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