Provider Demographics
NPI:1477577344
Name:MILBURN, DEBRA A (MS, LPC)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:A
Last Name:MILBURN
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 ROCK PRAIRIE RD STE B
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-8777
Mailing Address - Country:US
Mailing Address - Phone:979-693-5660
Mailing Address - Fax:979-694-7337
Practice Address - Street 1:207 ROCK PRAIRIE RD STE B
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-8777
Practice Address - Country:US
Practice Address - Phone:979-693-5660
Practice Address - Fax:979-694-7337
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12858101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
3020LCOtherBLUE CROSS & BLUE SHEILD