Provider Demographics
NPI:1598272254
Name:SARGEANT, DEBORAH (HAIR LOSS SPECIALIST)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:
Last Name:SARGEANT
Suffix:
Gender:F
Credentials:HAIR LOSS SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 MARLEY DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29210-6743
Mailing Address - Country:US
Mailing Address - Phone:803-556-6690
Mailing Address - Fax:
Practice Address - Street 1:7949 BROAD RIVER RD
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-2358
Practice Address - Country:US
Practice Address - Phone:803-556-6690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-03
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Single Specialty