Provider Demographics
NPI:1437473386
Name:MONACO, DEBRA J (CCC)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:J
Last Name:MONACO
Suffix:
Gender:F
Credentials:CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 DEER RUN CT
Mailing Address - Street 2:
Mailing Address - City:NORTH SALEM
Mailing Address - State:NY
Mailing Address - Zip Code:10560-3606
Mailing Address - Country:US
Mailing Address - Phone:914-669-8907
Mailing Address - Fax:
Practice Address - Street 1:12 DEER RUN CT
Practice Address - Street 2:
Practice Address - City:NORTH SALEM
Practice Address - State:NY
Practice Address - Zip Code:10560-3606
Practice Address - Country:US
Practice Address - Phone:914-669-8907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-22
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005489235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist