Provider Demographics
NPI:1215197769
Name:BAUDER, DEBORAH J (MED, CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:J
Last Name:BAUDER
Suffix:
Gender:F
Credentials:MED, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 MARIAN LN
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-1474
Mailing Address - Country:US
Mailing Address - Phone:615-785-1786
Mailing Address - Fax:
Practice Address - Street 1:1717 MARIAN LN
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-1474
Practice Address - Country:US
Practice Address - Phone:615-785-1786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000001809235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist