Provider Demographics
NPI:1659423036
Name:KEIM, DEBRA A (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:A
Last Name:KEIM
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2851 CENTRE AVE
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19605-2567
Mailing Address - Country:US
Mailing Address - Phone:610-750-6514
Mailing Address - Fax:610-750-6519
Practice Address - Street 1:2851 CENTRE AVE
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19605-2567
Practice Address - Country:US
Practice Address - Phone:610-750-6514
Practice Address - Fax:610-750-6519
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL004424L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist