Provider Demographics
NPI:1689984775
Name:WILLIAMS, DEBORAH RUTH (CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:RUTH
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:MRS
Other - First Name:DEBORAH
Other - Middle Name:RUTH
Other - Last Name:GERSCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:321 LIST AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-3125
Mailing Address - Country:US
Mailing Address - Phone:585-336-1605
Mailing Address - Fax:
Practice Address - Street 1:350 COOPER RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14617-3009
Practice Address - Country:US
Practice Address - Phone:585-336-1605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-07
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012106235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist