Provider Demographics
NPI:1437316940
Name:DELANGE, DEBORAH (MS)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:
Last Name:DELANGE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 N COTNER BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68505-2339
Mailing Address - Country:US
Mailing Address - Phone:402-464-8385
Mailing Address - Fax:402-464-8408
Practice Address - Street 1:630 N COTNER BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68505-2339
Practice Address - Country:US
Practice Address - Phone:402-464-8385
Practice Address - Fax:402-464-8408
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47071099104Medicaid