Provider Demographics
NPI:1912154576
Name:TOBAR, DEBRA J (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:J
Last Name:TOBAR
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 1:12 CROYDEN RD
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-4607
Mailing Address - Country:US
Mailing Address - Phone:516-214-4456
Mailing Address - Fax:
Practice Address - Street 1:12 CROYDEN RD
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-4607
Practice Address - Country:US
Practice Address - Phone:516-214-4456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013940-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist