Provider Demographics
NPI:1841476504
Name:COFRANCESCO, DEBORAH (CCC-SLP)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:COFRANCESCO
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 1:4315 WINCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:VICKSBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39180-8969
Mailing Address - Country:US
Mailing Address - Phone:601-634-0959
Mailing Address - Fax:
Practice Address - Street 1:4315 WINCHESTER RD
Practice Address - Street 2:
Practice Address - City:VICKSBURG
Practice Address - State:MS
Practice Address - Zip Code:39180-8969
Practice Address - Country:US
Practice Address - Phone:601-634-0959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-12
Last Update Date:2008-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS2279235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist