Provider Demographics
NPI:1114032034
Name:LURIA, DEBRA L (PHD, APRN, BC)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:L
Last Name:LURIA
Suffix:
Gender:F
Credentials:PHD, APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26111 W 14 MILE RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:FRANKLIN
Mailing Address - State:MI
Mailing Address - Zip Code:48025-1168
Mailing Address - Country:US
Mailing Address - Phone:248-626-4622
Mailing Address - Fax:248-626-2908
Practice Address - Street 1:26111 W 14 MILE RD
Practice Address - Street 2:SUITE 104
Practice Address - City:FRANKLIN
Practice Address - State:MI
Practice Address - Zip Code:48025-1168
Practice Address - Country:US
Practice Address - Phone:248-626-4622
Practice Address - Fax:248-626-2908
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301011628103T00000X
MI4704113893363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health