Provider Demographics
NPI:1467801688
Name:NEW, DEBRA
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:NEW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DEBBIE
Other - Middle Name:
Other - Last Name:NEW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7711 FOX HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34668-4066
Mailing Address - Country:US
Mailing Address - Phone:501-251-4173
Mailing Address - Fax:727-847-0480
Practice Address - Street 1:7711 FOX HOLLOW DR
Practice Address - Street 2:
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-4066
Practice Address - Country:US
Practice Address - Phone:501-251-4173
Practice Address - Fax:727-847-0480
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst