Provider Demographics
NPI:1467657395
Name:FISHER, DEBORAH J (MS CCC SLP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:J
Last Name:FISHER
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:980 5TH ST
Mailing Address - Street 2:
Mailing Address - City:GERING
Mailing Address - State:NE
Mailing Address - Zip Code:69341
Mailing Address - Country:US
Mailing Address - Phone:308-436-2279
Mailing Address - Fax:
Practice Address - Street 1:111 W 36TH ST
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-4623
Practice Address - Country:US
Practice Address - Phone:308-635-2019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE588235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist