Provider Demographics
NPI:1821287624
Name:SHARP, DEBORAH C (CCC/SLP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:C
Last Name:SHARP
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 1:2610 GUENEVERE AVE SE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35803-1936
Mailing Address - Country:US
Mailing Address - Phone:256-883-1667
Mailing Address - Fax:
Practice Address - Street 1:5275 MILLENNIUM DR NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806-2457
Practice Address - Country:US
Practice Address - Phone:256-489-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL739235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist