Provider Demographics
NPI:1073513750
Name:LEPOROWSKI, DEBORAH KIDD (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:KIDD
Last Name:LEPOROWSKI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 EDINBURGH COURT
Mailing Address - Street 2:#105
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607
Mailing Address - Country:US
Mailing Address - Phone:864-752-7577
Mailing Address - Fax:888-774-5337
Practice Address - Street 1:124 EDINBURGH COURT
Practice Address - Street 2:#105
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607
Practice Address - Country:US
Practice Address - Phone:864-752-7577
Practice Address - Fax:888-774-5337
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-26
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY4996103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL59510Medicare UPIN