Provider Demographics
NPI:1073692919
Name:BROWN, DEBORAH D (MA,CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:D
Last Name:BROWN
Suffix:
Gender:F
Credentials:MA,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:PO BOX 389
Mailing Address - Street 2:
Mailing Address - City:EL PRADO
Mailing Address - State:NM
Mailing Address - Zip Code:87529-0389
Mailing Address - Country:US
Mailing Address - Phone:505-758-7804
Mailing Address - Fax:
Practice Address - Street 1:19 ATILANO RD
Practice Address - Street 2:
Practice Address - City:EL PRADO
Practice Address - State:NM
Practice Address - Zip Code:87529-0389
Practice Address - Country:US
Practice Address - Phone:505-758-7804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3719235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist