Provider Demographics
NPI:1710322607
Name:WELLS, DEBORAH DEE (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:DEE
Last Name:WELLS
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2000 S. IH-35
Mailing Address - Street 2:STE. L-2
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681
Mailing Address - Country:US
Mailing Address - Phone:512-388-8904
Mailing Address - Fax:512-287-4214
Practice Address - Street 1:2000 S IH 35
Practice Address - Street 2:STE. L-2
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-6900
Practice Address - Country:US
Practice Address - Phone:512-388-8904
Practice Address - Fax:512-287-4214
Is Sole Proprietor?:No
Enumeration Date:2013-05-06
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP16274235Z00000X
TX108731235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist