Provider Demographics
NPI:1922205566
Name:MIORA, DEBORAH S (PHD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:S
Last Name:MIORA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:435 N ROXBURY DR
Mailing Address - Street 2:SUITE 406
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5027
Mailing Address - Country:US
Mailing Address - Phone:310-550-8443
Mailing Address - Fax:310-306-1612
Practice Address - Street 1:435 N ROXBURY DR
Practice Address - Street 2:SUITE 406
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5027
Practice Address - Country:US
Practice Address - Phone:310-550-8443
Practice Address - Fax:310-306-1612
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY11599103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist