Provider Demographics
NPI:1225584469
Name:HUBERT, MITCHEL SCOTT (BC-HIS)
Entity Type:Individual
Prefix:MR
First Name:MITCHEL
Middle Name:SCOTT
Last Name:HUBERT
Suffix:
Gender:M
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 GLENBROOK WAY STE 420
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-1246
Mailing Address - Country:US
Mailing Address - Phone:615-991-5145
Mailing Address - Fax:
Practice Address - Street 1:1050 GLENBROOK WAY STE 420
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-1246
Practice Address - Country:US
Practice Address - Phone:615-991-5145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-28
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN890237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist