Provider Demographics
NPI:1730942012
Name:HUBER, AILISHA-IRENE R
Entity type:Individual
Prefix:MRS
First Name:AILISHA-IRENE
Middle Name:R
Last Name:HUBER
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:AILISHA
Other - Middle Name:RENEE
Other - Last Name:HUBER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7108 S KANNER HWY
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-7462
Mailing Address - Country:US
Mailing Address - Phone:855-832-6727
Mailing Address - Fax:
Practice Address - Street 1:415 15TH AVE
Practice Address - Street 2:
Practice Address - City:BEAVER FALLS
Practice Address - State:PA
Practice Address - Zip Code:15010-2934
Practice Address - Country:US
Practice Address - Phone:412-414-2838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician