Provider Demographics
NPI:1245207620
Name:HULBERT-BILLINGS, JAINA RIAN (CCCSLP)
Entity Type:Individual
Prefix:MRS
First Name:JAINA
Middle Name:RIAN
Last Name:HULBERT-BILLINGS
Suffix:
Gender:F
Credentials:CCCSLP
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 82253
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99708
Mailing Address - Country:US
Mailing Address - Phone:907-488-2293
Mailing Address - Fax:
Practice Address - Street 1:1327 KALAKAKET STREET
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709
Practice Address - Country:US
Practice Address - Phone:907-452-4517
Practice Address - Fax:907-452-4263
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK115235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK115OtherSTATE LICENSE
AKSP2012Medicaid
A010OtherTRICARE