Provider Demographics
NPI:1316618267
Name:STEBBINS, NICOLE PAIGE (AUD)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:PAIGE
Last Name:STEBBINS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:903 W MARTIN ST # MS 49-2
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78207-0903
Mailing Address - Country:US
Mailing Address - Phone:201-358-5909
Mailing Address - Fax:210-358-5940
Practice Address - Street 1:9618 HUEBNER RD STE 310
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1777
Practice Address - Country:US
Practice Address - Phone:210-358-4583
Practice Address - Fax:210-702-2654
Is Sole Proprietor?:No
Enumeration Date:2021-09-21
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81814231H00000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist