Provider Demographics
NPI:1639307234
Name:HENNINGER, DEBRA (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:HENNINGER
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:TOWSON UNIVERSITY SLH CLINIC
Mailing Address - Street 2:8000 YORK ROAD
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21252-0001
Mailing Address - Country:US
Mailing Address - Phone:410-704-3095
Mailing Address - Fax:410-704-6303
Practice Address - Street 1:TOWSON UNIVERSITY SLH CLINIC
Practice Address - Street 2:8000 YORK ROAD
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21252-0001
Practice Address - Country:US
Practice Address - Phone:410-704-3095
Practice Address - Fax:410-704-6303
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00738235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist