Provider Demographics
NPI:1306394440
Name:DOBRICH, DEBORAH (MED)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:DOBRICH
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MED
Mailing Address - Street 1:9 HANOVER ST STE 2
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03766-1312
Mailing Address - Country:US
Mailing Address - Phone:603-448-0126
Mailing Address - Fax:603-448-6001
Practice Address - Street 1:85 MECHANIC ST # C2-1
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03766-1537
Practice Address - Country:US
Practice Address - Phone:603-448-5610
Practice Address - Fax:603-448-8260
Is Sole Proprietor?:No
Enumeration Date:2016-09-19
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3077550Medicaid
NH3077550Medicaid