Provider Demographics
NPI:1750591558
Name:HYBBEN, ERIKA CHRISTINE (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ERIKA
Middle Name:CHRISTINE
Last Name:HYBBEN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3136 50TH AVE
Mailing Address - Street 2:
Mailing Address - City:KNAPP
Mailing Address - State:WI
Mailing Address - Zip Code:54749-9011
Mailing Address - Country:US
Mailing Address - Phone:715-772-4667
Mailing Address - Fax:
Practice Address - Street 1:3136 50TH AVE
Practice Address - Street 2:
Practice Address - City:KNAPP
Practice Address - State:WI
Practice Address - Zip Code:54749-9011
Practice Address - Country:US
Practice Address - Phone:715-772-4667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2190154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42560700Medicaid