Provider Demographics
NPI:1548413081
Name:MOLIERE HUBBARD, TORI M (MED CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:TORI
Middle Name:M
Last Name:MOLIERE HUBBARD
Suffix:
Gender:F
Credentials:MED CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9844 WESTERLY AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70814-4222
Mailing Address - Country:US
Mailing Address - Phone:225-281-4614
Mailing Address - Fax:225-201-1827
Practice Address - Street 1:9844 WESTERLY AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70814-4222
Practice Address - Country:US
Practice Address - Phone:225-281-4614
Practice Address - Fax:225-201-1827
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5247235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist