Provider Demographics
NPI:1407559560
Name:DUKES, DEBRA (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:
Last Name:DUKES
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MRS
Other - First Name:DEBRA
Other - Middle Name:
Other - Last Name:DUKES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:2462 VALLEY LN
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-8149
Mailing Address - Country:US
Mailing Address - Phone:810-516-1711
Mailing Address - Fax:810-516-1711
Practice Address - Street 1:2462 VALLEY LN
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-8149
Practice Address - Country:US
Practice Address - Phone:810-516-1711
Practice Address - Fax:810-516-1711
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010898671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical