Provider Demographics
NPI:1588828255
Name:DUVALL, DEBORAH OWENS
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:OWENS
Last Name:DUVALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1870 DESTINY LANE
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-1639
Mailing Address - Country:US
Mailing Address - Phone:270-320-0414
Mailing Address - Fax:
Practice Address - Street 1:U.S. DEPARTMENT OF VETERANS AFFAIRS
Practice Address - Street 2:1310 24TH AVE. SO
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212
Practice Address - Country:US
Practice Address - Phone:615-367-8829
Practice Address - Fax:615-366-4048
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-11
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY34741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical