Provider Demographics
NPI:1326281908
Name:RUBEN, LYNNE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LYNNE
Middle Name:
Last Name:RUBEN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 HIGH RIDGE RD
Mailing Address - Street 2:#3511
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-7801
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19 HIGH RIDGE RD
Practice Address - Street 2:#3511
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-7801
Practice Address - Country:US
Practice Address - Phone:203-883-9432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-13
Last Update Date:2014-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003553235Z00000X
NY017891235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist