Provider Demographics
NPI:1629381371
Name:BOBBIN, VALERIA BUCKNER (MSE-MS-CCC/L)
Entity Type:Individual
Prefix:
First Name:VALERIA
Middle Name:BUCKNER
Last Name:BOBBIN
Suffix:
Gender:F
Credentials:MSE-MS-CCC/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 DEVEAU RD
Mailing Address - Street 2:
Mailing Address - City:NORTH SALEM
Mailing Address - State:NY
Mailing Address - Zip Code:10560-2115
Mailing Address - Country:US
Mailing Address - Phone:914-669-5984
Mailing Address - Fax:914-206-7119
Practice Address - Street 1:15 PARK PLACE
Practice Address - Street 2:BRONXVILLE CENTER FOR LANGUAGE & LEARNING
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708
Practice Address - Country:US
Practice Address - Phone:914-337-6357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-23
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0071718235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist