Provider Demographics
NPI:1598001976
Name:AHARON, DEVORAH AMY (SLP)
Entity Type:Individual
Prefix:MRS
First Name:DEVORAH
Middle Name:AMY
Last Name:AHARON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MRS
Other - First Name:DEBBIE
Other - Middle Name:AMY
Other - Last Name:AHARON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:9007 CRESTA DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-4114
Mailing Address - Country:US
Mailing Address - Phone:310-497-4668
Mailing Address - Fax:
Practice Address - Street 1:9007 CRESTA DR
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-4114
Practice Address - Country:US
Practice Address - Phone:310-497-4668
Practice Address - Fax:818-788-1135
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-12
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP20176235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASP20176OtherSPEECH THERAPY