Provider Demographics
NPI:1376895037
Name:NAHRA, DEBORAH KAY (MACCCSLP)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:KAY
Last Name:NAHRA
Suffix:
Gender:F
Credentials:MACCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6170 BRENTCREST DR
Mailing Address - Street 2:
Mailing Address - City:NASHPORT
Mailing Address - State:OH
Mailing Address - Zip Code:43830-9565
Mailing Address - Country:US
Mailing Address - Phone:740-607-2417
Mailing Address - Fax:
Practice Address - Street 1:1945 TAMARACK RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-1300
Practice Address - Country:US
Practice Address - Phone:740-349-9777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-04
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3866235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist