Provider Demographics
NPI:1588847032
Name:DEBICCARI, GRACE (MA;CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:GRACE
Middle Name:
Last Name:DEBICCARI
Suffix:
Gender:F
Credentials:MA;CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1729 QUARTER ST
Mailing Address - Street 2:
Mailing Address - City:WEST BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11704-7013
Mailing Address - Country:US
Mailing Address - Phone:631-275-4062
Mailing Address - Fax:
Practice Address - Street 1:1729 QUARTER ST
Practice Address - Street 2:
Practice Address - City:WEST BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11704-7013
Practice Address - Country:US
Practice Address - Phone:631-275-4062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-06
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015719235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist