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General NPI Number Information
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NPI Number | 1679897995
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Entity Type | Organization
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Legal Business Name | THE AUBIN APHASIA SPEECH AND LANGUAGE CENTER LLC
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Dates
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Enumeration Date | 03/15/2010
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Last Update Date | 03/16/2022
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Provider Practice Location Address
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Address Line | 330 MADISON AVE S STE 106
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City | BAINBRIDGE ISLAND
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State | WA
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Zip | 98110-2544
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Country | US
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Telephone | 206-355-9985
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Fax |
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Provider Business Mailing Address
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Address Line | 330 MADISON AVE S STE 106
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City | BAINBRIDGE ISLAND
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State | WA
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Zip | 98110-2544
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Country | US
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Telephone | 206-355-9985
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Fax |
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Authorized Official
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Title or Position | LLC MANAGER
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Name | MS. JESSICA L AUBIN
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Credential | MS CCC SLP
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Telephone | 206-355-9985
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number | LL00004536
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License Number State | WA
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