Provider Demographics
NPI:1164110169
Name:JUDI DOBNER SPEECH THERAPY PLLC
Entity Type:Organization
Organization Name:JUDI DOBNER SPEECH THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JUDI
Authorized Official - Middle Name:
Authorized Official - Last Name:DOBNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-304-1309
Mailing Address - Street 1:386 ROUTE 59 STE 102
Mailing Address - Street 2:
Mailing Address - City:AIRMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10952-3428
Mailing Address - Country:US
Mailing Address - Phone:845-368-7927
Mailing Address - Fax:845-388-7929
Practice Address - Street 1:386 ROUTE 59 STE 102
Practice Address - Street 2:
Practice Address - City:AIRMONT
Practice Address - State:NY
Practice Address - Zip Code:10952-3428
Practice Address - Country:US
Practice Address - Phone:845-368-7927
Practice Address - Fax:845-388-7929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty