| Doctor Name: | MS. DEIRDRE LYNNE MAYBANK |
| NPI Number: | 1326320102 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A., CCC-SLP |
| License Number: | SLP007696 |
| Business Practice Address: | 2720 Sheraton Dr Suite D-140 Macon, GA - 312041167 |
| Business Phone Number: | 4787410019 |
| Business Fax Number: | 4787421308 |
| Mailing Address: | 1901 Century Blvd Ne, Suite 20 ATLANTA |
| State: | GA |
| Postal Code: | 303453300 |
| Phone Number: | 4046338911 |
| Fax Number: | 4046336403 |
| NPI Enumeration Date: | 09/16/2011 |
| NPI Last Update Date: | 09/16/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SLP007696 |
| 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 |