Provider Demographics
NPI:1780001214
Name:KUBANY, AMANDA
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:KUBANY
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:AMANDA
Other - Middle Name:MARIE
Other - Last Name:HALES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3205 S RURAL RD
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-3853
Mailing Address - Country:US
Mailing Address - Phone:480-720-7100
Mailing Address - Fax:
Practice Address - Street 1:3205 S RURAL RD
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-3853
Practice Address - Country:US
Practice Address - Phone:480-720-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-21
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSL2355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant