Provider Demographics
NPI:1043349897
Name:WILKINS, DEBORAH LYNN (M ED CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:LYNN
Last Name:WILKINS
Suffix:
Gender:F
Credentials:M ED CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 N A ST
Mailing Address - Street 2:BUILDING 1 STE 244
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79705-5421
Mailing Address - Country:US
Mailing Address - Phone:432-570-4400
Mailing Address - Fax:
Practice Address - Street 1:3300 N A ST
Practice Address - Street 2:BUILDING 1 STE 244
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79705-5421
Practice Address - Country:US
Practice Address - Phone:432-570-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15099235Z00000X
NM3550235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM26485877Medicaid