Provider Demographics
NPI:1417013863
Name:KADOW, DEBRA S
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:S
Last Name:KADOW
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:PO BOX 3082
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30719-0082
Mailing Address - Country:US
Mailing Address - Phone:706-260-9378
Mailing Address - Fax:
Practice Address - Street 1:1043 LAURA DR
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30721-7987
Practice Address - Country:US
Practice Address - Phone:706-260-9378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker