Provider Demographics
NPI:1558411637
Name:MUMM FELNAGLE, DEBRA I (MA LMHC)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:I
Last Name:MUMM FELNAGLE
Suffix:
Gender:F
Credentials:MA LMHC
Other - Prefix:MS
Other - First Name:DEBRA
Other - Middle Name:I
Other - Last Name:MUMM FELNAGLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA LMHC
Mailing Address - Street 1:1618 WILTON RD S
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98465-1035
Mailing Address - Country:US
Mailing Address - Phone:253-564-8113
Mailing Address - Fax:
Practice Address - Street 1:1618 WILTON RD S
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98465-1035
Practice Address - Country:US
Practice Address - Phone:253-564-8113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00004544101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health