Provider Demographics
NPI:1376631820
Name:WATERMAN, DEBORAH ELLYN (PHD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:ELLYN
Last Name:WATERMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:DEBORAH
Other - Middle Name:ELLYN
Other - Last Name:LEHRMAN-WATERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:1 COBBLESTONE CT
Mailing Address - Street 2:
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-1774
Mailing Address - Country:US
Mailing Address - Phone:610-399-7057
Mailing Address - Fax:
Practice Address - Street 1:1546 MCDANIEL DR
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-7035
Practice Address - Country:US
Practice Address - Phone:610-399-7057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS015001103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1370686OtherBLUE CROSS/BLUE SHIELD