Provider Demographics
NPI:1457704587
Name:DOUBLIN, RENEE (SLP)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:DOUBLIN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 JOE CLIFTON DR
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001-3747
Mailing Address - Country:US
Mailing Address - Phone:270-415-3618
Mailing Address - Fax:270-444-2380
Practice Address - Street 1:911 JOE CLIFTON DR
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-3747
Practice Address - Country:US
Practice Address - Phone:270-415-3618
Practice Address - Fax:270-444-2380
Is Sole Proprietor?:No
Enumeration Date:2016-07-13
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY139909235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist