Basic Information
| Provider Information | |||||||||
| NPI: | 1861826729 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PONTORNO | ||||||||
| FirstName: | DEBORAH | ||||||||
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| Credential: | SPEECH PATHOLOGIST | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1160 S CENTRAL AVE | ||||||||
| Address2: | |||||||||
| City: | LAUREL | ||||||||
| State: | DE | ||||||||
| PostalCode: | 199561418 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026844950 | ||||||||
| FaxNumber: | 3026848931 | ||||||||
| Practice Location | |||||||||
| Address1: | 1160 S CENTRAL AVE | ||||||||
| Address2: | |||||||||
| City: | LAUREL | ||||||||
| State: | DE | ||||||||
| PostalCode: | 199561418 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026844950 | ||||||||
| FaxNumber: | 3026848931 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/28/2013 | ||||||||
| LastUpdateDate: | 08/28/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | O1-0001305 | DE | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.