Provider Demographics
NPI:1003239823
Name:ELDRIDGE, DEBORAH QUARTEL
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:QUARTEL
Last Name:ELDRIDGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:LYNN
Other - Last Name:QUARTEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2870 PHEASANT FIELD DR
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-7707
Mailing Address - Country:US
Mailing Address - Phone:614-499-4276
Mailing Address - Fax:
Practice Address - Street 1:2870 PHEASANT FIELD DR
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-7707
Practice Address - Country:US
Practice Address - Phone:614-499-4276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-30
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRJ165353235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist