Provider Demographics
NPI:1619978459
Name:BECKLEY, DEBORAH P (CCC, SLP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:P
Last Name:BECKLEY
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 1:241 GREENHOUSE RD
Mailing Address - Street 2:ATTN: STEPHANIE BLACK
Mailing Address - City:LEXINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24450-3717
Mailing Address - Country:US
Mailing Address - Phone:540-463-3141
Mailing Address - Fax:540-464-4051
Practice Address - Street 1:241 GREENHOUSE RD
Practice Address - Street 2:ATTN: STEPHANIE BLACK
Practice Address - City:LEXINGTON
Practice Address - State:VA
Practice Address - Zip Code:24450-3717
Practice Address - Country:US
Practice Address - Phone:540-463-3141
Practice Address - Fax:540-464-4051
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202000389235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist