Provider Demographics
NPI:1275600512
Name:CASSAVANT, DEBBIE (HS DIPLOMA)
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:
Last Name:CASSAVANT
Suffix:
Gender:F
Credentials:HS DIPLOMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:247 N DORCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03266-6208
Mailing Address - Country:US
Mailing Address - Phone:603-536-1118
Mailing Address - Fax:
Practice Address - Street 1:111 CHURCH ST
Practice Address - Street 2:
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-3432
Practice Address - Country:US
Practice Address - Phone:603-536-1118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health