Provider Demographics
NPI:1245474345
Name:MORENO, DEBORAH LEE (MS CCC/SLP)
Entity type:Individual
Prefix:MISS
First Name:DEBORAH
Middle Name:LEE
Last Name:MORENO
Suffix:
Gender:F
Credentials:MS CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:506 S CLOSNER BLVD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-4660
Mailing Address - Country:US
Mailing Address - Phone:956-381-4345
Mailing Address - Fax:956-381-4348
Practice Address - Street 1:506 S CLOSNER BLVD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-4660
Practice Address - Country:US
Practice Address - Phone:956-381-4345
Practice Address - Fax:956-381-4348
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-21
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
TX103945235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist