Provider Demographics
NPI:1558419069
Name:FLOWERS, DEBORAH M (CCCSLP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:M
Last Name:FLOWERS
Suffix:
Gender:F
Credentials:CCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 DUNGAN DR NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30152-5473
Mailing Address - Country:US
Mailing Address - Phone:864-582-2881
Mailing Address - Fax:864-542-9741
Practice Address - Street 1:470 CLARA DR
Practice Address - Street 2:
Practice Address - City:WHITESBURG
Practice Address - State:GA
Practice Address - Zip Code:30185-2531
Practice Address - Country:US
Practice Address - Phone:770-214-0536
Practice Address - Fax:770-214-0537
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP003340235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist