Provider Demographics
NPI:1558628636
Name:CARD, DEBORAH (SLP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:CARD
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 HIGHWAY 60 WEST
Mailing Address - Street 2:SOCORRO GENERAL HOSPITAL
Mailing Address - City:SOCORRO
Mailing Address - State:NM
Mailing Address - Zip Code:87801-3914
Mailing Address - Country:US
Mailing Address - Phone:575-835-1140
Mailing Address - Fax:
Practice Address - Street 1:1202 HIGHWAY 60 WEST
Practice Address - Street 2:SOCORRO GENERAL HOSPITAL
Practice Address - City:SOCORRO
Practice Address - State:NM
Practice Address - Zip Code:87801-3914
Practice Address - Country:US
Practice Address - Phone:575-835-1140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-13
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM4301235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist