Doctor Name: | CARLA DEBLECOURT |
NPI Number: | 1942610415 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MACCC/SLP |
License Number: | 7101000464 |
Business Practice Address: | 2575 N Drake Rd Kalamazoo, MI - 490061358 |
Business Phone Number: | 2693420206 |
Business Fax Number: | |
Mailing Address: | 5639 Pleasant Meadow Trl, SCHOOLCRAFT |
State: | MI |
Postal Code: | 490878107 |
Phone Number: | 2693532747 |
Fax Number: | |
NPI Enumeration Date: | 05/05/2014 |
NPI Last Update Date: | 05/05/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 7101000464 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
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 |