Provider Demographics
NPI:1407003361
Name:THOMAS, DEBORA ANNE (MSCCCSLP)
Entity Type:Individual
Prefix:MRS
First Name:DEBORA
Middle Name:ANNE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MSCCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 SHOEMAKER RD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-8730
Mailing Address - Country:US
Mailing Address - Phone:585-670-9921
Mailing Address - Fax:
Practice Address - Street 1:900 SHOEMAKER RD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-8730
Practice Address - Country:US
Practice Address - Phone:585-670-9921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-22
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009520-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00357240Medicaid