Provider Demographics
NPI:1255860193
Name:HATFIELD, DEBRA LYNN WEISS (MED, EDS, LMHC)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:LYNN WEISS
Last Name:HATFIELD
Suffix:
Gender:F
Credentials:MED, EDS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2240 NW 40TH TER STE A
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-3590
Mailing Address - Country:US
Mailing Address - Phone:352-378-0900
Mailing Address - Fax:352-378-7849
Practice Address - Street 1:2240 NW 40TH TER STE A
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-3590
Practice Address - Country:US
Practice Address - Phone:352-378-0900
Practice Address - Fax:352-378-7849
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-05
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH13288101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor