Provider Demographics
NPI:1538498332
Name:STAPLEY, DEBORAH R (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:R
Last Name:STAPLEY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 S HILLSIDE DR
Mailing Address - Street 2:
Mailing Address - City:KANAB
Mailing Address - State:UT
Mailing Address - Zip Code:84741-3818
Mailing Address - Country:US
Mailing Address - Phone:435-689-1582
Mailing Address - Fax:
Practice Address - Street 1:931 S HILLSIDE DR
Practice Address - Street 2:
Practice Address - City:KANAB
Practice Address - State:UT
Practice Address - Zip Code:84741-3818
Practice Address - Country:US
Practice Address - Phone:435-689-1582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-08
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP6480235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist