Provider Demographics
NPI:1396862041
Name:TWE, DEBORAH D (MSW)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:D
Last Name:TWE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 S EDWIN C MOSES BLVD
Mailing Address - Street 2:FIRST FLOOR, NW BUILDING
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45408-1424
Mailing Address - Country:US
Mailing Address - Phone:937-224-1694
Mailing Address - Fax:
Practice Address - Street 1:601 S EDWIN C MOSES BLVD
Practice Address - Street 2:FIRST FLOOR, NW BUILDING
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45408-1424
Practice Address - Country:US
Practice Address - Phone:937-224-1694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-00035181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHTWSW26201Medicare ID - Type UnspecifiedMEDICARE