Provider Demographics
NPI:1376867085
Name:FASH, DEBORAH S (SLP-CCC)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:S
Last Name:FASH
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 N 77TH ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85257-3776
Mailing Address - Country:US
Mailing Address - Phone:480-946-9112
Mailing Address - Fax:840-946-2657
Practice Address - Street 1:1300 N 77TH ST
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85257-3776
Practice Address - Country:US
Practice Address - Phone:480-946-9112
Practice Address - Fax:840-946-2657
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-24
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP0120235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist