Provider Demographics
NPI:1720004427
Name:REYNOLD, DEBORAH KAYE (MS,CCC,SLP)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:KAYE
Last Name:REYNOLD
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 1:1407 E THURSTON AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-4242
Mailing Address - Country:US
Mailing Address - Phone:509-838-3341
Mailing Address - Fax:
Practice Address - Street 1:1407 E THURSTON AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203-4242
Practice Address - Country:US
Practice Address - Phone:509-838-3341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALLOOOO2836235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist