Provider Demographics
NPI:1457511107
Name:NUNNALLY, DEBORAH ALLEN (MSW)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:ALLEN
Last Name:NUNNALLY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:995 9TH AVE SW
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35022-4527
Mailing Address - Country:US
Mailing Address - Phone:205-481-7997
Mailing Address - Fax:205-481-7815
Practice Address - Street 1:4810 S SHADES CREST RD
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35022-4311
Practice Address - Country:US
Practice Address - Phone:205-426-6563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1567C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL631279880OtherITIN