Provider Demographics
NPI:1669672853
Name:KLUTTZ, DEBRA B (LCSW)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:B
Last Name:KLUTTZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MOORE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:BRISTOL
Mailing Address - State:VA
Mailing Address - Zip Code:24201-4337
Mailing Address - Country:US
Mailing Address - Phone:276-591-5301
Mailing Address - Fax:276-591-5304
Practice Address - Street 1:300 MOORE ST
Practice Address - Street 2:SUITE A
Practice Address - City:BRISTOL
Practice Address - State:VA
Practice Address - Zip Code:24201-4337
Practice Address - Country:US
Practice Address - Phone:276-591-5301
Practice Address - Fax:276-591-5304
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040065461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical