Provider Demographics
NPI:1518224278
Name:SHEA, DEBORAH LONGAKER (CCC-A)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:LONGAKER
Last Name:SHEA
Suffix:
Gender:F
Credentials:CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3812 WELLESLEY TERRACE CIR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233-7700
Mailing Address - Country:US
Mailing Address - Phone:804-514-7284
Mailing Address - Fax:
Practice Address - Street 1:3812 WELLESLEY TERRACE CIR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-7700
Practice Address - Country:US
Practice Address - Phone:804-514-7284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-19
Last Update Date:2022-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201001238231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist