Provider Demographics
NPI:1619102720
Name:SALES, DEBRA (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:
Last Name:SALES
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1133 MIDLAND AVE
Mailing Address - Street 2:1D
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-6464
Mailing Address - Country:US
Mailing Address - Phone:516-557-3938
Mailing Address - Fax:
Practice Address - Street 1:1133 MIDLAND AVE
Practice Address - Street 2:1D
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-6464
Practice Address - Country:US
Practice Address - Phone:516-557-3938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-18
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015921-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist