Provider Demographics
NPI:1609968916
Name:MIGYANKO, DEBORAH MARIE (LSW)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:MARIE
Last Name:MIGYANKO
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 W MAIN ST
Mailing Address - Street 2:SUITE 704
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-3309
Mailing Address - Country:US
Mailing Address - Phone:724-439-9698
Mailing Address - Fax:
Practice Address - Street 1:50 W MAIN ST
Practice Address - Street 2:SUITE 704
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-3309
Practice Address - Country:US
Practice Address - Phone:724-439-9698
Practice Address - Fax:724-439-9701
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007288440074Medicaid
PAA336347OtherVALUE BEHAVIORAL HEALTH