Provider Demographics
NPI:1750505426
Name:CIARLO, DEBRA ANNE (SLP, LMHC)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:ANNE
Last Name:CIARLO
Suffix:
Gender:F
Credentials:SLP, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 METHOW ST
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-2927
Mailing Address - Country:US
Mailing Address - Phone:509-662-3762
Mailing Address - Fax:509-662-3762
Practice Address - Street 1:210 METHOW ST
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-2927
Practice Address - Country:US
Practice Address - Phone:509-662-3762
Practice Address - Fax:509-662-3762
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00010914101YM0800X
WALL00003214235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7088370Medicaid