Provider Demographics
NPI:1578775813
Name:KUBINSKI, DEBRA ANN
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:ANN
Last Name:KUBINSKI
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 1:45023 ROLLING RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-1824
Mailing Address - Country:US
Mailing Address - Phone:734-459-7763
Mailing Address - Fax:
Practice Address - Street 1:26847 GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48240-1544
Practice Address - Country:US
Practice Address - Phone:313-535-7275
Practice Address - Fax:313-535-7275
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI09118348235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist