Provider Demographics
NPI:1326320102
Name:ROZIER, DEIRDRE MAYBANK (MA, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:DEIRDRE
Middle Name:MAYBANK
Last Name:ROZIER
Suffix:
Gender:
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:DEIRDRE
Other - Middle Name:LYNNE
Other - Last Name:MAYBANK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:509 MILLBILL LN
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:SC
Mailing Address - Zip Code:29045-9844
Mailing Address - Country:US
Mailing Address - Phone:803-387-7944
Mailing Address - Fax:
Practice Address - Street 1:6901 N CHARLES ST
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-3780
Practice Address - Country:US
Practice Address - Phone:443-809-4130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-16
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP007696235Z00000X
MD11370235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist