Healthcare Provider Details

I. General information

NPI: 1629442140
Provider Name (Legal Business Name): DEBORAH KRILL MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2015
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7896 SHANLEY RD APT 1
WATERVILLE NY
13480-1325
US

IV. Provider business mailing address

7896 SHANLEY RD APT 1
WATERVILLE NY
13480-1325
US

V. Phone/Fax

Practice location:
  • Phone: 518-925-0466
  • Fax:
Mailing address:
  • Phone: 518-925-0466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number008623
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: