MEDICARE: MS. DEBORAH ALLEN BEFFA MS/CCC/SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	09126754	MO

General Provider Information

NPI Number	:	1154652683
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBORAH ALLEN BEFFA MS/CCC/SLP

Provider Business Mailing Address
First Line	:	17207 WINDSOR CREST BLVD
Second Line	:
City	:	WILDWOOD
State	:	MO
Zip	:	63038-1396
Country	:	US
Telephone Number	:	314-518-4009
Fax Number	:

Provider Business Practice Location Address
First Line	:	17207 WINDSOR CREST BLVD
Second Line	:
City	:	WILDWOOD
State	:	MO
Zip	:	63038-1396
Country	:	US
Telephone Number	:	314-518-4009
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/22/2010
Last Update Date	:	01/22/2010

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