Provider Demographics
NPI:1861796294
Name:GALE, DEBORAH C (MS, CCC-SLP, CBIS)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:C
Last Name:GALE
Suffix:
Gender:F
Credentials:MS, CCC-SLP, CBIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6120 BRANDON AVE
Mailing Address - Street 2:#315
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22150-2522
Mailing Address - Country:US
Mailing Address - Phone:703-362-5376
Mailing Address - Fax:703-560-7151
Practice Address - Street 1:6120 BRANDON AVE
Practice Address - Street 2:#315
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-2522
Practice Address - Country:US
Practice Address - Phone:703-362-5376
Practice Address - Fax:703-560-7151
Is Sole Proprietor?:No
Enumeration Date:2010-12-28
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202001032235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist