Provider Demographics
NPI:1861285611
Name:GOYKADOSH, DEBORA (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:DEBORA
Middle Name:
Last Name:GOYKADOSH
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 1:6207 WINNER AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-3735
Mailing Address - Country:US
Mailing Address - Phone:516-476-1910
Mailing Address - Fax:
Practice Address - Street 1:6717 CHOKEBERRY RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-1451
Practice Address - Country:US
Practice Address - Phone:410-216-0236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD11502235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist