Provider Demographics
NPI:1669983250
Name:RAINER, DEBORAH FLETCHER (SLP)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:FLETCHER
Last Name:RAINER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2683 BURL LN
Mailing Address - Street 2:
Mailing Address - City:LORENA
Mailing Address - State:TX
Mailing Address - Zip Code:76655-9401
Mailing Address - Country:US
Mailing Address - Phone:254-717-0664
Mailing Address - Fax:
Practice Address - Street 1:2683 BURL LN
Practice Address - Street 2:
Practice Address - City:LORENA
Practice Address - State:TX
Practice Address - Zip Code:76655-9401
Practice Address - Country:US
Practice Address - Phone:254-717-0664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11203235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist