Provider Demographics
NPI:1073824728
Name:CANNON, DEBORAH DANIELLE (MS CFY-SLP)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:DANIELLE
Last Name:CANNON
Suffix:
Gender:F
Credentials:MS CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6019 NW 53RD TER
Mailing Address - Street 2:
Mailing Address - City:WARR ACRES
Mailing Address - State:OK
Mailing Address - Zip Code:73122-6040
Mailing Address - Country:US
Mailing Address - Phone:405-812-3468
Mailing Address - Fax:
Practice Address - Street 1:6019 NW 53RD TER
Practice Address - Street 2:
Practice Address - City:WARR ACRES
Practice Address - State:OK
Practice Address - Zip Code:73122-6040
Practice Address - Country:US
Practice Address - Phone:405-812-3468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-28
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist