Provider Demographics
NPI:1861746141
Name:ADAMS, DEBRA (MS CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:
Last Name:ADAMS
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 1:16 PARKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:ME
Mailing Address - Zip Code:04346-5429
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:466 ACADEMY RD
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:ME
Practice Address - Zip Code:04350-3648
Practice Address - Country:US
Practice Address - Phone:207-268-4137
Practice Address - Fax:207-268-2680
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP1131235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist