Provider Demographics
NPI:1194003251
Name:CULBERTSON, DEBORAH M (MCD, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:M
Last Name:CULBERTSON
Suffix:
Gender:F
Credentials:MCD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:410 E BUTLER RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:MAULDIN
Mailing Address - State:SC
Mailing Address - Zip Code:29662-3250
Mailing Address - Country:US
Mailing Address - Phone:864-569-1599
Mailing Address - Fax:864-963-3477
Practice Address - Street 1:410 E BUTLER RD
Practice Address - Street 2:SUITE D
Practice Address - City:MAULDIN
Practice Address - State:SC
Practice Address - Zip Code:29662-3250
Practice Address - Country:US
Practice Address - Phone:864-569-1599
Practice Address - Fax:864-963-3477
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-23
Last Update Date:2011-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3806235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist