Provider Demographics
NPI:1164693438
Name:SPINKS, DEBORAH EILEEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:EILEEN
Last Name:SPINKS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 SOLAR ST
Mailing Address - Street 2:APT. 502
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13204-1492
Mailing Address - Country:US
Mailing Address - Phone:302-753-6746
Mailing Address - Fax:
Practice Address - Street 1:750 E ADAMS ST
Practice Address - Street 2:RM N2104
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-2342
Practice Address - Country:US
Practice Address - Phone:315-464-2300
Practice Address - Fax:315-464-2305
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017556103TC0700X, 103TC2200X, 103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation