Provider Demographics
NPI:1275637902
Name:BUBNICK, EMILY S
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:S
Last Name:BUBNICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-4717
Mailing Address - Country:US
Mailing Address - Phone:513-863-3264
Mailing Address - Fax:513-285-7631
Practice Address - Street 1:402 MAIN ST
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-4717
Practice Address - Country:US
Practice Address - Phone:513-863-3264
Practice Address - Fax:513-285-7631
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA00822231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist