Provider Demographics
NPI:1194003558
Name:HUBA, ALVIN WALTER (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALVIN
Middle Name:WALTER
Last Name:HUBA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10511 CRYSTAL RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-7940
Mailing Address - Country:US
Mailing Address - Phone:352-250-9763
Mailing Address - Fax:
Practice Address - Street 1:10511 CRYSTAL RIDGE CT
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-7940
Practice Address - Country:US
Practice Address - Phone:352-250-9763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-02
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst