Provider Demographics
NPI:1861544611
Name:MACHESKY, DEANNA EVERETT (M ED, CCC-SLP)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:EVERETT
Last Name:MACHESKY
Suffix:
Gender:F
Credentials:M ED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4308 ALBINO DEER WAY
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-3971
Mailing Address - Country:US
Mailing Address - Phone:919-624-9295
Mailing Address - Fax:
Practice Address - Street 1:9716 LAYLA AVE.
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-4290
Practice Address - Country:US
Practice Address - Phone:919-624-9295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6324235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist