Provider Demographics
NPI:1598171373
Name:AVERY, DEBORAH (HIS)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:AVERY
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 PALMER RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:MONSON
Mailing Address - State:MA
Mailing Address - Zip Code:01057-9576
Mailing Address - Country:US
Mailing Address - Phone:413-893-9423
Mailing Address - Fax:413-893-9463
Practice Address - Street 1:8 HERITAGE LN
Practice Address - Street 2:
Practice Address - City:MONSON
Practice Address - State:MA
Practice Address - Zip Code:01057-1157
Practice Address - Country:US
Practice Address - Phone:413-893-9423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-01
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA246237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist