Provider Demographics
NPI:1003965989
Name:BOXER, DEBRA E (MSW)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:E
Last Name:BOXER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 684
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04070-0684
Mailing Address - Country:US
Mailing Address - Phone:207-883-3922
Mailing Address - Fax:207-883-3922
Practice Address - Street 1:605 US ROUTE 1
Practice Address - Street 2:SUITE 5
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-9617
Practice Address - Country:US
Practice Address - Phone:207-883-3922
Practice Address - Fax:207-883-3922
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME3496101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
5060267Medicare UPIN
ME003816Medicare UPIN
MEMM3208Medicare ID - Type Unspecified