Provider Demographics
NPI:1376624585
Name:KATZ, DEBRA (SLP)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:
Last Name:KATZ
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3531 KIMMER ROWE DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-6703
Mailing Address - Country:US
Mailing Address - Phone:850-668-0318
Mailing Address - Fax:
Practice Address - Street 1:107 REGIONAL REHAB
Practice Address - Street 2:FLORIDA STATE UNIVERSITY
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32306
Practice Address - Country:US
Practice Address - Phone:850-644-8451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLS610235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist