Provider Demographics
NPI:1811122401
Name:SHARPE, DEBORAH J (CCC-SLP)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:J
Last Name:SHARPE
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 1:221 VAN VOAST AVE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:KY
Mailing Address - Zip Code:41073-1207
Mailing Address - Country:US
Mailing Address - Phone:479-530-7249
Mailing Address - Fax:
Practice Address - Street 1:425 GARRARD ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:KY
Practice Address - Zip Code:41011-2562
Practice Address - Country:US
Practice Address - Phone:859-581-9393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-26
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-3404235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist