Provider Demographics
NPI:1538860929
Name:GARLAND, DEEANNA ALICE (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:DEEANNA
Middle Name:ALICE
Last Name:GARLAND
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:439 E VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91741-2158
Mailing Address - Country:US
Mailing Address - Phone:626-260-1938
Mailing Address - Fax:
Practice Address - Street 1:439 E VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91741-2158
Practice Address - Country:US
Practice Address - Phone:626-260-1938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP25879235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist