Provider Demographics
NPI:1811510456
Name:SMILOW, DEBRA DEVORAH (MS/CCC-SLP)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:DEVORAH
Last Name:SMILOW
Suffix:
Gender:F
Credentials:MS/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:PO BOX 480227
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-1227
Mailing Address - Country:US
Mailing Address - Phone:323-556-4870
Mailing Address - Fax:
Practice Address - Street 1:222 S MCCADDEN PL
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90004-1054
Practice Address - Country:US
Practice Address - Phone:323-556-4870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-18
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist