Individual
CARLA DEBLECOURT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MACCC/SLP
Contact information
Practice address
2575 N DRAKE RD, KALAMAZOO, MI 49006-1358
(269) 342-0206
Mailing address
5639 PLEASANT MEADOW TRL, SCHOOLCRAFT, MI 49087-8107
(269) 353-2747
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101000464
MI
Other
Enumeration date
05/05/2014
Last updated
05/05/2014
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