Provider Demographics
NPI:1275104341
Name:HOBAN, BRIDGET ABIGAIL (MS)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:ABIGAIL
Last Name:HOBAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 W LA JOLLA DR APT 1053
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-4451
Mailing Address - Country:US
Mailing Address - Phone:507-381-2801
Mailing Address - Fax:
Practice Address - Street 1:1525 W FRYE RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-6112
Practice Address - Country:US
Practice Address - Phone:480-812-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTSLP13184235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist