Provider Demographics
NPI:1144634130
Name:HEBBELER, EMILY
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:HEBBELER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2243 JANES LN
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41011-4045
Mailing Address - Country:US
Mailing Address - Phone:859-512-3037
Mailing Address - Fax:
Practice Address - Street 1:905 HIGHWAY 127 N
Practice Address - Street 2:
Practice Address - City:OWENTON
Practice Address - State:KY
Practice Address - Zip Code:40359-9302
Practice Address - Country:US
Practice Address - Phone:502-484-0661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-17
Last Update Date:2014-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2013-074235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist