Provider Demographics
NPI:1760292890
Name:HUBAY, ADRIENNE SHAW
Entity type:Individual
Prefix:MRS
First Name:ADRIENNE
Middle Name:SHAW
Last Name:HUBAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ADRIENNE
Other - Middle Name:SHAW
Other - Last Name:ASHWORTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:259 S DICK CREEK RD
Mailing Address - Street 2:
Mailing Address - City:LA FAYETTE
Mailing Address - State:GA
Mailing Address - Zip Code:30728-5484
Mailing Address - Country:US
Mailing Address - Phone:706-386-8083
Mailing Address - Fax:
Practice Address - Street 1:259 S DICK CREEK RD
Practice Address - Street 2:
Practice Address - City:LA FAYETTE
Practice Address - State:GA
Practice Address - Zip Code:30728-5484
Practice Address - Country:US
Practice Address - Phone:706-386-8083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-10
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician