Provider Demographics
NPI:1003138199
Name:DABLER, KAY ANN (SLP)
Entity Type:Individual
Prefix:
First Name:KAY
Middle Name:ANN
Last Name:DABLER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 E WASHINGTON ST
Mailing Address - Street 2:SUITE PA-2
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-6450
Mailing Address - Country:US
Mailing Address - Phone:909-825-6716
Mailing Address - Fax:909-825-4339
Practice Address - Street 1:301 S FAIR OAKS AVE
Practice Address - Street 2:SUITE 401
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2561
Practice Address - Country:US
Practice Address - Phone:626-744-0411
Practice Address - Fax:626-744-0431
Is Sole Proprietor?:No
Enumeration Date:2010-02-17
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP 16362235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist