Provider Demographics
NPI:1134483035
Name:UBBENGA, JULIA ANN
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:ANN
Last Name:UBBENGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13333 BLANCO RD
Mailing Address - Street 2:STE. 302
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-2138
Mailing Address - Country:US
Mailing Address - Phone:210-883-7879
Mailing Address - Fax:210-492-4588
Practice Address - Street 1:13333 BLANCO RD
Practice Address - Street 2:STE. 302
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-2138
Practice Address - Country:US
Practice Address - Phone:210-883-7879
Practice Address - Fax:210-492-4588
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107472235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist