Provider Demographics
NPI:1144536731
Name:KUBLIN, KARY S (PHD, CCC-SLP)
Entity type:Individual
Prefix:
First Name:KARY
Middle Name:S
Last Name:KUBLIN
Suffix:
Gender:F
Credentials:PHD, 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:PO BOX 7528
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32314-7528
Mailing Address - Country:US
Mailing Address - Phone:850-510-6202
Mailing Address - Fax:850-576-6418
Practice Address - Street 1:3913 CATES AVE
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32310-4905
Practice Address - Country:US
Practice Address - Phone:850-510-6202
Practice Address - Fax:850-576-6418
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA2407235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist