Provider Demographics
NPI:1740336072
Name:MANLIEF, DEBORAH SUE (MA,CCC-SLP)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:SUE
Last Name:MANLIEF
Suffix:
Gender:F
Credentials:MA,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3805 E STATE ROAD 244
Mailing Address - Street 2:
Mailing Address - City:RUSHVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46173-7962
Mailing Address - Country:US
Mailing Address - Phone:765-629-2733
Mailing Address - Fax:
Practice Address - Street 1:3805 E STATE ROAD 244
Practice Address - Street 2:
Practice Address - City:RUSHVILLE
Practice Address - State:IN
Practice Address - Zip Code:46173-7962
Practice Address - Country:US
Practice Address - Phone:765-629-2733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22002629A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist