Provider Demographics
NPI:1841443058
Name:DEBIASE, AMY B (MS, SLP/CCC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:B
Last Name:DEBIASE
Suffix:
Gender:F
Credentials:MS, SLP/CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 STURBRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-4030
Mailing Address - Country:US
Mailing Address - Phone:585-385-7662
Mailing Address - Fax:
Practice Address - Street 1:60 STURBRIDGE LN
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-4030
Practice Address - Country:US
Practice Address - Phone:585-385-7662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-31
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012886-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist