Provider Demographics
NPI:1215421003
Name:POLLOCK, DEANNA MARIE (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:MARIE
Last Name:POLLOCK
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MISS
Other - First Name:DEANNA
Other - Middle Name:MARIE
Other - Last Name:DAMELE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:678 WOLCOTT DR
Mailing Address - Street 2:
Mailing Address - City:SPRING CREEK
Mailing Address - State:NV
Mailing Address - Zip Code:89815-7028
Mailing Address - Country:US
Mailing Address - Phone:775-318-0958
Mailing Address - Fax:
Practice Address - Street 1:1020 RUBY VISTA DR UNIT 102
Practice Address - Street 2:
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801-2876
Practice Address - Country:US
Practice Address - Phone:775-753-1214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-15
Last Update Date:2018-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP-2135235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist