Provider Demographics
NPI:1588195804
Name:ROSENTHAL, DEBORAH (PHD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:
Last Name:ROSENTHAL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 634
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:OH
Mailing Address - Zip Code:44202-0634
Mailing Address - Country:US
Mailing Address - Phone:440-546-0048
Mailing Address - Fax:
Practice Address - Street 1:8180 BRECKSVILLE RD
Practice Address - Street 2:SUITE 115
Practice Address - City:BRECKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44141-1374
Practice Address - Country:US
Practice Address - Phone:440-546-0048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-27
Last Update Date:2017-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7532103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical