Provider Demographics
NPI:1497803530
Name:HUBBARD, NANCY (MA CCC)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:MA CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 ROCKLAND ST
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04856-4809
Mailing Address - Country:US
Mailing Address - Phone:207-596-9999
Mailing Address - Fax:207-596-6899
Practice Address - Street 1:235 ROCKLAND ST
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:ME
Practice Address - Zip Code:04856-4809
Practice Address - Country:US
Practice Address - Phone:207-596-9999
Practice Address - Fax:207-596-6899
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1235235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME06105OtherANTHEM