Provider Demographics
NPI:1194832410
Name:STEIN, DEBRA LEE (LP)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:LEE
Last Name:STEIN
Suffix:
Gender:F
Credentials:LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 1/2 7TH ST NW
Mailing Address - Street 2:SUITE 216
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901
Mailing Address - Country:US
Mailing Address - Phone:507-252-9292
Mailing Address - Fax:507-232-9203
Practice Address - Street 1:1210 1/2 7TH ST NW
Practice Address - Street 2:SUITE 216
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901
Practice Address - Country:US
Practice Address - Phone:507-252-9292
Practice Address - Fax:507-232-9203
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP3022103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN124048OtherUCARE
MN91622OtherMAYO MMSI
MN9H611STOtherBCBS OF MN PROVIDER
MN9H612STOtherBCBS OF MN INDIVIDUAL
MN6254214OtherUNITED BEHAVIORAL HEALTH
MN87767OtherHEALTH PARTNERS