Provider Demographics
NPI:1467600437
Name:FOURNIER, DEBRA J (LIC AC)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:J
Last Name:FOURNIER
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 KALEVA RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:MA
Mailing Address - Zip Code:01523-3213
Mailing Address - Country:US
Mailing Address - Phone:978-534-5388
Mailing Address - Fax:
Practice Address - Street 1:59 MERRIAM AVE
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-3158
Practice Address - Country:US
Practice Address - Phone:978-534-5388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA529171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist