Provider Demographics
NPI:1871519512
Name:RANNIE, DEBORAH STUART (MS-CCCSLP)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:STUART
Last Name:RANNIE
Suffix:
Gender:F
Credentials:MS-CCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:643 HAMPTON DOWNS CT
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32259-7979
Mailing Address - Country:US
Mailing Address - Phone:904-860-6992
Mailing Address - Fax:
Practice Address - Street 1:643 HAMPTON DOWNS CT
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32259-7979
Practice Address - Country:US
Practice Address - Phone:904-860-6992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA2858235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL8912068Medicaid