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NPI Code Detail

MEDICARE: DEBORAH GRACE BROUGHTON CCC-SLP

MEDICARE:   DEBORAH GRACE BROUGHTON  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
1235Z00000XSpeech-Language Pathologist5989SC

General Provider Information

NPI Number : 1467952184
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH GRACE BROUGHTON CCC-SLP
Provider Business Mailing Address
First Line : 1809 DAMON DR
Second Line :
City : FLORENCE
State : SC
Zip : 29505-3116
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 319 GARLINGTON RD STE B5
Second Line :
City : GREENVILLE
State : SC
Zip : 29615-4621
Country : US
Telephone Number : 864-991-7035
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2018
Last Update Date : 02/19/2018

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Directions to “ DEBORAH GRACE BROUGHTON CCC-SLP” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.