Provider Demographics
NPI:1659467181
Name:REUMANN, DEBORAH ANNE (LISW)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANNE
Last Name:REUMANN
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1119 DOUGLAS AVE.
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NM
Mailing Address - Zip Code:87701-3932
Mailing Address - Country:US
Mailing Address - Phone:505-718-6930
Mailing Address - Fax:505-454-3083
Practice Address - Street 1:1119 DOUGLAS AVE.
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NM
Practice Address - Zip Code:87701-3932
Practice Address - Country:US
Practice Address - Phone:505-718-6930
Practice Address - Fax:505-454-3803
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-41161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM000G1676Medicaid