Provider Demographics
NPI:1245223551
Name:MACK, DEBBIE MONY (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBBIE
Middle Name:MONY
Last Name:MACK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:823 SCRABBLE RD
Mailing Address - Street 2:
Mailing Address - City:CASTLETON
Mailing Address - State:VA
Mailing Address - Zip Code:22716-2920
Mailing Address - Country:US
Mailing Address - Phone:540-937-7864
Mailing Address - Fax:540-937-2002
Practice Address - Street 1:823 SCRABBLE RD
Practice Address - Street 2:
Practice Address - City:CASTLETON
Practice Address - State:VA
Practice Address - Zip Code:22716-2920
Practice Address - Country:US
Practice Address - Phone:540-937-7864
Practice Address - Fax:540-937-2002
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010505682084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry