Provider Demographics
NPI:1740231414
Name:DEES, DEBORAH L (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:L
Last Name:DEES
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2183 FOREST GATE DR E
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32246-1127
Mailing Address - Country:US
Mailing Address - Phone:904-607-8269
Mailing Address - Fax:904-220-4215
Practice Address - Street 1:2183 FOREST GATE DR E
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32246-1127
Practice Address - Country:US
Practice Address - Phone:904-607-8269
Practice Address - Fax:904-220-4215
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 5666235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist