Provider Demographics
NPI:1245577618
Name:RICHARD, DEBBIE G (PHD)
Entity Type:Individual
Prefix:DR
First Name:DEBBIE
Middle Name:G
Last Name:RICHARD
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 1:280 SMITH RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CAMPBELLSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42718-8614
Mailing Address - Country:US
Mailing Address - Phone:502-381-1848
Mailing Address - Fax:
Practice Address - Street 1:280 SMITH RIDGE RD
Practice Address - Street 2:
Practice Address - City:CAMPBELLSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42718-8614
Practice Address - Country:US
Practice Address - Phone:502-381-1848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-05
Last Update Date:2013-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0526101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional