Provider Demographics
NPI:1457839722
Name:MUENCH, DEBORAH MADISON (PHD, BCBA)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:MADISON
Last Name:MUENCH
Suffix:
Gender:F
Credentials:PHD, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 HOUNDS RUN
Mailing Address - Street 2:
Mailing Address - City:SAFETY HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34695-4446
Mailing Address - Country:US
Mailing Address - Phone:508-579-0090
Mailing Address - Fax:
Practice Address - Street 1:1 MIFFLIN PL STE 400
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-4946
Practice Address - Country:US
Practice Address - Phone:508-579-0090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-30
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-11-8829103K00000X
MA9481103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst