Provider Demographics
NPI:1962676858
Name:DABEL, DEBORA ANN (MS CCC- SLP)
Entity Type:Individual
Prefix:MRS
First Name:DEBORA
Middle Name:ANN
Last Name:DABEL
Suffix:
Gender:F
Credentials:MS CCC- SLP
Other - Prefix:MRS
Other - First Name:DEB
Other - Middle Name:ANN
Other - Last Name:DABEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:6581 ROUND LAKE RD
Mailing Address - Street 2:
Mailing Address - City:RHINELANDER
Mailing Address - State:WI
Mailing Address - Zip Code:54501-8155
Mailing Address - Country:US
Mailing Address - Phone:715-282-5574
Mailing Address - Fax:
Practice Address - Street 1:729 PARK ST
Practice Address - Street 2:
Practice Address - City:ANTIGO
Practice Address - State:WI
Practice Address - Zip Code:54409-2745
Practice Address - Country:US
Practice Address - Phone:715-623-2356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI40-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42698300Medicaid
WI40-154OtherWI STATE LICENSURE