Individual
CARLY MARIE DEEGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC/SLP
Contact information
Practice address
6245 STATE ROAD 54, NEW PORT RICHEY, FL 34653-6006
(727) 376-1111
(727) 376-1113
Mailing address
6245 STATE ROAD 54, NEW PORT RICHEY, FL 34653-6006
(727) 376-1111
(727) 376-1113
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA18493
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SA18493
ST OF FL, DEPT OF HEALTH, BRD OF SLP
FL
Enumeration date
11/13/2020
Last updated
11/13/2020
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