Provider Demographics
NPI:1033256359
Name:DUBEAU, CHRISTINE JANELLE (CCC-SLP/L)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:JANELLE
Last Name:DUBEAU
Suffix:
Gender:F
Credentials:CCC-SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1062 PARK CT
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-5566
Mailing Address - Country:US
Mailing Address - Phone:630-742-6238
Mailing Address - Fax:
Practice Address - Street 1:1062 PARK CT
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-5566
Practice Address - Country:US
Practice Address - Phone:630-742-6238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.007046235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist