Provider Demographics
NPI:1568767770
Name:DERAMUS, MARGARET LANE (PHD, CCC-SLP)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:LANE
Last Name:DERAMUS
Suffix:
Gender:F
Credentials:PHD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:101 RENEE LYNNE CT
Mailing Address - Street 2:
Mailing Address - City:CARRBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27510-6511
Mailing Address - Country:US
Mailing Address - Phone:919-843-5941
Mailing Address - Fax:919-966-2230
Practice Address - Street 1:101 RENEE LYNNE CT
Practice Address - Street 2:
Practice Address - City:CARRBORO
Practice Address - State:NC
Practice Address - Zip Code:27510-6511
Practice Address - Country:US
Practice Address - Phone:919-843-5941
Practice Address - Fax:919-966-2230
Is Sole Proprietor?:No
Enumeration Date:2011-01-19
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9008235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2419153Medicare PIN
NCOTH000Medicare UPIN