Provider Demographics
NPI:1497866321
Name:KNOX, DEBRA GAIL (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:GAIL
Last Name:KNOX
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 1:9425 SW 72ND ST
Mailing Address - Street 2:SUITE 261
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3251
Mailing Address - Country:US
Mailing Address - Phone:305-271-7343
Mailing Address - Fax:305-271-7949
Practice Address - Street 1:9425 SW 72ND ST
Practice Address - Street 2:SUITE 261
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3251
Practice Address - Country:US
Practice Address - Phone:305-271-7343
Practice Address - Fax:305-271-7949
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 5933235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL888395500Medicaid