Provider Demographics
NPI:1811222599
Name:DWYER, DEBRA LYNNE (CLC, CD, CLMT)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:LYNNE
Last Name:DWYER
Suffix:
Gender:F
Credentials:CLC, CD, CLMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8333
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01971-8333
Mailing Address - Country:US
Mailing Address - Phone:978-578-8570
Mailing Address - Fax:
Practice Address - Street 1:35 CABOT ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-4641
Practice Address - Country:US
Practice Address - Phone:978-578-8570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-13
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula