Provider Demographics
NPI:1225469075
Name:UBBEN, POLLY (MA, CCC-SLP-L)
Entity Type:Individual
Prefix:MRS
First Name:POLLY
Middle Name:
Last Name:UBBEN
Suffix:
Gender:F
Credentials:MA, 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:PO BOX 5285
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68802-5285
Mailing Address - Country:US
Mailing Address - Phone:308-675-1853
Mailing Address - Fax:308-210-4121
Practice Address - Street 1:4001 O ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-1755
Practice Address - Country:US
Practice Address - Phone:402-817-0834
Practice Address - Fax:402-817-0835
Is Sole Proprietor?:No
Enumeration Date:2013-12-04
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE715235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist