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Individual

DEIRDRE A NORTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
SLP-CCC

Contact information

Practice address
1101 W VICKERY BLVD, FORT WORTH, TX 76104
(682) 885-6294
(682) 885-1135
Mailing address
PO BOX 99283, FT WORTH, TX 76199-1383
(682) 885-6294
(682) 885-1135

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
112124
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
149984001
TX
05
207164901
TX
Enumeration date
12/20/2010
Last updated
08/16/2018
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