Provider Demographics
NPI:1053634741
Name:TAGABAN, KAYE LENE (SLPA)
Entity Type:Individual
Prefix:MRS
First Name:KAYE
Middle Name:LENE
Last Name:TAGABAN
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-2973
Mailing Address - Country:US
Mailing Address - Phone:928-502-4300
Mailing Address - Fax:928-502-4444
Practice Address - Street 1:600 S 21ST AVE
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-2727
Practice Address - Country:US
Practice Address - Phone:928-502-8050
Practice Address - Fax:928-502-8082
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA62962355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant