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Individual

MRS. DEBORAH M. VANCE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CCC,SLP

Contact information

Practice address
3816 N ELM ST STE E, GREENSBORO, NC 27455-2776
(336) 370-4070
(336) 370-9008
Mailing address
2109 ROSEMONT DR, COLFAX, NC 27235-9638
(336) 688-2591

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
406
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
013X1
BCBS GROUP PROV. #
NC
01
137KF
BCBS INDIV.PROVIDER#
NC
01
7211258
MEDICAID GROUP PROV. #
NC
05
7411224
NC
Enumeration date
01/22/2007
Last updated
08/26/2010
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