Provider Demographics
NPI:1508092115
Name:DOBNER, JUDI (MS CCC / SLP)
Entity Type:Individual
Prefix:
First Name:JUDI
Middle Name:
Last Name:DOBNER
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 1:7 BARTLETT RD
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-1706
Mailing Address - Country:US
Mailing Address - Phone:845-352-9205
Mailing Address - Fax:845-352-0688
Practice Address - Street 1:7 BARTLETT RD
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-1706
Practice Address - Country:US
Practice Address - Phone:845-352-9205
Practice Address - Fax:845-352-0688
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-09
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004158235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist