Provider Demographics
NPI:1881888709
Name:MULLIN, DEBORAH ASHLEY (CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:ASHLEY
Last Name:MULLIN
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 1:405 SE 2ND AVE
Mailing Address - Street 2:SUITE 15
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-5805
Mailing Address - Country:US
Mailing Address - Phone:352-216-4436
Mailing Address - Fax:
Practice Address - Street 1:681 BEVILLE RD
Practice Address - Street 2:
Practice Address - City:SOUTH DAYTONA
Practice Address - State:FL
Practice Address - Zip Code:32119-1951
Practice Address - Country:US
Practice Address - Phone:866-426-2811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ3969235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist