Provider Demographics
NPI:1235129305
Name:DEMING, DEA LUCINDA (MS CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:DEA
Middle Name:LUCINDA
Last Name:DEMING
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:DEA
Other - Middle Name:LUCINDA
Other - Last Name:ALIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4915 TROYDALE RD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-4311
Mailing Address - Country:US
Mailing Address - Phone:813-882-3465
Mailing Address - Fax:813-882-3465
Practice Address - Street 1:4915 TROYDALE RD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-4311
Practice Address - Country:US
Practice Address - Phone:813-882-3465
Practice Address - Fax:813-882-3465
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-28
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA162235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist