Provider Demographics
NPI:1164504312
Name:DEVINE, DEBBIE (MS LPC)
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:
Last Name:DEVINE
Suffix:
Gender:F
Credentials:MS LPC
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 594
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-0594
Mailing Address - Country:US
Mailing Address - Phone:214-410-0435
Mailing Address - Fax:972-672-1957
Practice Address - Street 1:562 W RALPH M HALL PKWY
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-6644
Practice Address - Country:US
Practice Address - Phone:214-410-0435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14377101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional