Provider Demographics
NPI:1992043681
Name:SPEER, DEBRA SUE
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:SUE
Last Name:SPEER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 W MODELLE AVE
Mailing Address - Street 2:APT 2
Mailing Address - City:CLINTON
Mailing Address - State:OK
Mailing Address - Zip Code:73601-3738
Mailing Address - Country:US
Mailing Address - Phone:580-323-2260
Mailing Address - Fax:
Practice Address - Street 1:2201 W MODELLE AVE
Practice Address - Street 2:APT 2
Practice Address - City:CLINTON
Practice Address - State:OK
Practice Address - Zip Code:73601-3738
Practice Address - Country:US
Practice Address - Phone:580-323-2260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-30
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health