Provider Demographics
NPI:1568735835
Name:CLAUSON, DEBORA ANN
Entity Type:Individual
Prefix:MRS
First Name:DEBORA
Middle Name:ANN
Last Name:CLAUSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:POB 540
Mailing Address - Street 2:
Mailing Address - City:SINCLAIRVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14782-0540
Mailing Address - Country:US
Mailing Address - Phone:716-962-5155
Mailing Address - Fax:
Practice Address - Street 1:43 SINCLAIR DRIVE
Practice Address - Street 2:SINCLAIRVILLE ELEMENTARY
Practice Address - City:SINCLAIRVILLE
Practice Address - State:NY
Practice Address - Zip Code:14782
Practice Address - Country:US
Practice Address - Phone:716-962-5195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-17
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007662-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist