Provider Demographics
NPI:1679665905
Name:CHARZEWSKI, DEBRA B (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:B
Last Name:CHARZEWSKI
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 1:85 SCENIC DRIVE
Mailing Address - Street 2:
Mailing Address - City:WEST WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02893-5499
Mailing Address - Country:US
Mailing Address - Phone:401-333-1135
Mailing Address - Fax:401-277-3366
Practice Address - Street 1:134 THURBERS AVE.
Practice Address - Street 2:C/O FAMILY SERVICE OF RHODE ISLAND
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905
Practice Address - Country:US
Practice Address - Phone:401-331-1350
Practice Address - Fax:401-277-3366
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RISP00722235Z00000X
MA5883235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
46-00025OtherUNITED HEALTH
27260-1OtherBLUE CROSS/BLUE SHIELD
411520OtherBLUE CHIP