Provider Demographics
NPI:1750671871
Name:RUBIO, PAULETTE ANGELIQUE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:PAULETTE
Middle Name:ANGELIQUE
Last Name:RUBIO
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 1:71 THEA LN
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:NC
Mailing Address - Zip Code:28732-5629
Mailing Address - Country:US
Mailing Address - Phone:828-545-0799
Mailing Address - Fax:
Practice Address - Street 1:71 THEA LN
Practice Address - Street 2:
Practice Address - City:FLETCHER
Practice Address - State:NC
Practice Address - Zip Code:28732-5629
Practice Address - Country:US
Practice Address - Phone:828-545-0799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-11
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8723235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist