Provider Demographics
NPI:1871890467
Name:ABSHERE, DEBORAH LESLIE (MEDCCCSLP)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:LESLIE
Last Name:ABSHERE
Suffix:
Gender:F
Credentials:MEDCCCSLP
Other - Prefix:MS
Other - First Name:DEBORAH
Other - Middle Name:LESLIE
Other - Last Name:COOPER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MEDCCCSLP
Mailing Address - Street 1:909 GLENMARK CT
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-1818
Mailing Address - Country:US
Mailing Address - Phone:405-751-2198
Mailing Address - Fax:
Practice Address - Street 1:909 GLENMARK CT
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-1818
Practice Address - Country:US
Practice Address - Phone:405-751-2198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-17
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK936235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist