Provider Demographics
NPI:1568687994
Name:CAIN, DEBRA MARIE (EDS)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:MARIE
Last Name:CAIN
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 CRANE MILL RD
Mailing Address - Street 2:
Mailing Address - City:CORNELIA
Mailing Address - State:GA
Mailing Address - Zip Code:30531-4899
Mailing Address - Country:US
Mailing Address - Phone:706-778-5547
Mailing Address - Fax:
Practice Address - Street 1:4601 CRANE MILL RD
Practice Address - Street 2:
Practice Address - City:CORNELIA
Practice Address - State:GA
Practice Address - Zip Code:30531-4899
Practice Address - Country:US
Practice Address - Phone:706-778-5547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP001700235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist