Provider Demographics
NPI:1194124305
Name:GERING, DEBORAH DIANE
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:DIANE
Last Name:GERING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13838 SHADOW WAY
Mailing Address - Street 2:
Mailing Address - City:GREENTOP
Mailing Address - State:MO
Mailing Address - Zip Code:63546-2309
Mailing Address - Country:US
Mailing Address - Phone:660-349-6521
Mailing Address - Fax:660-665-3281
Practice Address - Street 1:1901 E HAMILTON ST
Practice Address - Street 2:
Practice Address - City:KIRKSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63501-3904
Practice Address - Country:US
Practice Address - Phone:660-665-7774
Practice Address - Fax:660-665-3281
Is Sole Proprietor?:No
Enumeration Date:2014-08-14
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004023914235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2013040773OtherSPEECH AND LANGUAGE PATHOLOGIST