Provider Demographics
NPI:1750857983
Name:HUBLER, ANN LYDIA (SLP)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:LYDIA
Last Name:HUBLER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:LYDIA
Other - Last Name:MISCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:21055 DINGMAN SLAGLE RD
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:OH
Mailing Address - Zip Code:45365-9139
Mailing Address - Country:US
Mailing Address - Phone:937-492-9772
Mailing Address - Fax:
Practice Address - Street 1:21055 DINGMAN SLAGLE RD
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:OH
Practice Address - Zip Code:45365-9139
Practice Address - Country:US
Practice Address - Phone:937-492-9772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-15
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH05769235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist