Provider Demographics
NPI:1154300358
Name:CRAGUN, DEBORAH LE (MS)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:LE
Last Name:CRAGUN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1933 CHAUCER DR
Mailing Address - Street 2:UNIT D
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45237-1308
Mailing Address - Country:US
Mailing Address - Phone:513-821-4015
Mailing Address - Fax:513-636-7297
Practice Address - Street 1:3333 BURNET AVE
Practice Address - Street 2:MLC 4006
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-636-9861
Practice Address - Fax:513-636-7297
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-16
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS