Provider Demographics
NPI:1366491276
Name:BALDWIN, DEBORA KRISTEN (MS,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:DEBORA
Middle Name:KRISTEN
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2321 HUNTSBORO LN
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-8116
Mailing Address - Country:US
Mailing Address - Phone:479-530-6022
Mailing Address - Fax:
Practice Address - Street 1:2474 E JOYCE BLVD
Practice Address - Street 2:STE 2
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-4519
Practice Address - Country:US
Practice Address - Phone:479-521-8326
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1797235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist