Provider Demographics
NPI:1184836892
Name:STEIN, DEBRA ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:ANN
Last Name:STEIN
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 1:7201 N.E. BAY HARBOUR AVE.
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-1707
Mailing Address - Country:US
Mailing Address - Phone:561-998-9040
Mailing Address - Fax:561-998-9040
Practice Address - Street 1:950 PENINSU;LA CORPORATE CIRCLE
Practice Address - Street 2:SUITE 3000
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487
Practice Address - Country:US
Practice Address - Phone:561-999-8881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7133103TC0700X
NJ35S100346000103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL75022AOtherBLUE CROSS BLUE SHIELD FL
FLU6441BMedicare UPIN