Doctor Name: | MRS. DEBORAH HANSARD RIVERS |
NPI Number: | 1265685788 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.ED., CCC-SLP |
License Number: | SLP006389 |
Business Practice Address: | 130 Pine Knott Rd Fayetteville, GA - 302143230 |
Business Phone Number: | 7703062784 |
Business Fax Number: | 7703062784 |
Mailing Address: | 130 Pine Knott Rd, FAYETTEVILLE |
State: | GA |
Postal Code: | 302143230 |
Phone Number: | 7703062784 |
Fax Number: | 7703062784 |
NPI Enumeration Date: | 10/28/2008 |
NPI Last Update Date: | 10/28/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SLP006389 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |