Provider Demographics
NPI:1548662901
Name:BAME, DEBRA ELLA (MA ED SLP/L)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:ELLA
Last Name:BAME
Suffix:
Gender:F
Credentials:MA ED SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 MINERVA ST
Mailing Address - Street 2:
Mailing Address - City:TIFFIN
Mailing Address - State:OH
Mailing Address - Zip Code:44883-1560
Mailing Address - Country:US
Mailing Address - Phone:419-447-1566
Mailing Address - Fax:419-448-5219
Practice Address - Street 1:130 MINERVA ST
Practice Address - Street 2:
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44883-1560
Practice Address - Country:US
Practice Address - Phone:419-447-1566
Practice Address - Fax:419-448-5219
Is Sole Proprietor?:No
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP. 7335235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist