Provider Demographics
NPI:1427181460
Name:HOAG, DEBORAH L (LISAC MA)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:L
Last Name:HOAG
Suffix:
Gender:F
Credentials:LISAC MA
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:L
Other - Last Name:FINLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2550 SHOW LOW LAKE ROAD
Mailing Address - Street 2:
Mailing Address - City:SHOW LOW
Mailing Address - State:AZ
Mailing Address - Zip Code:85901
Mailing Address - Country:US
Mailing Address - Phone:928-537-1029
Mailing Address - Fax:928-537-9049
Practice Address - Street 1:2550 SHOW LOW LAKE ROAD
Practice Address - Street 2:
Practice Address - City:SHOW LOW
Practice Address - State:AZ
Practice Address - Zip Code:85901
Practice Address - Country:US
Practice Address - Phone:928-537-1029
Practice Address - Fax:928-537-9049
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC10573101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ168042OtherAHCCCS