Dora Deller, MS, CCC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7101000855 Issued in MI

Practice address

5601 Hatchery Rd
Waterford, MI 48329-3451

Phone

(248) 674-9292

NPI assigned

Apr 21, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• JS Therapies, LLC

  • Occupational Therapist
  • Christiansted, VI
  • NPI 1154608016
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1366502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366502400000",
    "number": "1629412630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54109 SUNDERLAND DR",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483161970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 HATCHERY RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483293451",
            "telephone_number": "248-674-9292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELLER",
        "first_name": "DORA",
        "credential": "MS, CCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-21",
        "last_updated": "2013-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101000855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN DEPT OF LICENSING AND REGULATORY AFFAIRS",
            "identifier": "7101000855",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Degroff Orthopedic Supplies Inc.
• Mark Degroff
• Melissa Degroff, LMSW
• James Raymond Delaney III, D.D.S.
• Keith I Delap, D.C.
• Jennifer Delong
• Deluxe Dental Associates 10- Waterford PLLC
• Marguerite E. Demaria, OTR/L
• David Denova
• Avinash M Desai, MD

• Speech-Language Pathologist in Waterford, MI
• Providers in Waterford, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.