Provider Demographics
NPI:1043407794
Name:ALLMAN-REYNOLDS, DEBORAH LYNN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:LYNN
Last Name:ALLMAN-REYNOLDS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 BANGS WAY
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99709-4050
Mailing Address - Country:US
Mailing Address - Phone:907-978-4095
Mailing Address - Fax:000-000-0000
Practice Address - Street 1:1420 BANGS WAY
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709-4050
Practice Address - Country:US
Practice Address - Phone:907-978-4095
Practice Address - Fax:000-000-0000
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-26
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK2611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical