Provider Demographics
NPI:1912165986
Name:BAUER, DEBRA B (MA, CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:B
Last Name:BAUER
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 STATE ROAD 436
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-6100
Mailing Address - Country:US
Mailing Address - Phone:407-678-8000
Mailing Address - Fax:407-678-7763
Practice Address - Street 1:1120 STATE ROAD 436
Practice Address - Street 2:SUITE 1200
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-6100
Practice Address - Country:US
Practice Address - Phone:407-678-8000
Practice Address - Fax:407-678-7763
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY-785231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist