Provider Demographics
NPI:1407129216
Name:FABEL, DEBORAH M
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:M
Last Name:FABEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 STATE STREET
Mailing Address - Street 2:SUITE 227
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092
Mailing Address - Country:US
Mailing Address - Phone:817-703-2468
Mailing Address - Fax:
Practice Address - Street 1:112 STATE ST
Practice Address - Street 2:SUITE 227
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-7622
Practice Address - Country:US
Practice Address - Phone:817-703-2468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-10
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67423101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional