Provider Demographics
NPI:1598272320
Name:PIVEC, DEBORAH JONES
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:JONES
Last Name:PIVEC
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 1:3901 DARLEIGH RD APT B
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-5810
Mailing Address - Country:US
Mailing Address - Phone:443-413-2567
Mailing Address - Fax:
Practice Address - Street 1:1131 BENFIELD BLVD
Practice Address - Street 2:
Practice Address - City:MILLERSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21108-2600
Practice Address - Country:US
Practice Address - Phone:410-846-5282
Practice Address - Fax:443-688-6354
Is Sole Proprietor?:No
Enumeration Date:2018-01-02
Last Update Date:2018-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00614235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist