Provider Demographics
NPI:1053595108
Name:SMITH, DEBORAH SUE (SPEECH PATHOLOGIST)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:SUE
Last Name:SMITH
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Gender:F
Credentials:SPEECH PATHOLOGIST
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Mailing Address - Street 1:36000 DARNALL LOOP
Mailing Address - Street 2:CARL R. DARNALL ARMY MEDICAL CENTER
Mailing Address - City:FORT HOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76544
Mailing Address - Country:US
Mailing Address - Phone:254-288-8457
Mailing Address - Fax:254-286-7993
Practice Address - Street 1:36000 DARNALL LOOP
Practice Address - Street 2:CARL R. DARNALL ARMY MEDICAL CENTER
Practice Address - City:FORT HOOD
Practice Address - State:TX
Practice Address - Zip Code:76544
Practice Address - Country:US
Practice Address - Phone:254-288-8457
Practice Address - Fax:254-286-7993
Is Sole Proprietor?:No
Enumeration Date:2007-12-26
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX11103235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist