Provider Demographics
NPI:1396866893
Name:EDWARDS, DEBORAH ABBOTT (LAPC)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ABBOTT
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1652 HEATHERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-1707
Mailing Address - Country:US
Mailing Address - Phone:404-982-9145
Mailing Address - Fax:
Practice Address - Street 1:1652 HEATHERWOOD DR
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-1707
Practice Address - Country:US
Practice Address - Phone:404-982-9145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000977101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional