Provider Demographics
NPI:1114222585
Name:SPAULDING, DEBRA D
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:D
Last Name:SPAULDING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 HWY. 515
Mailing Address - Street 2:SUITE D
Mailing Address - City:BLAIRSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30512-7830
Mailing Address - Country:US
Mailing Address - Phone:706-745-0091
Mailing Address - Fax:706-745-0099
Practice Address - Street 1:411 HWY. 515
Practice Address - Street 2:SUITE D
Practice Address - City:BLAIRSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30512-7830
Practice Address - Country:US
Practice Address - Phone:706-745-0091
Practice Address - Fax:706-745-0099
Is Sole Proprietor?:No
Enumeration Date:2011-01-17
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
237700000X
GAHADS00836237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist