Provider Demographics
NPI:1184790404
Name:VANAKEN, DEBORAH B (PHD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:B
Last Name:VANAKEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 BOWMANS DRIVE
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:PA
Mailing Address - Zip Code:18938
Mailing Address - Country:US
Mailing Address - Phone:215-862-8133
Mailing Address - Fax:215-862-2355
Practice Address - Street 1:46 BOWMANS DRIVE
Practice Address - Street 2:
Practice Address - City:NEW HOPE
Practice Address - State:PA
Practice Address - Zip Code:18938
Practice Address - Country:US
Practice Address - Phone:215-862-8133
Practice Address - Fax:215-862-2355
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS 005078L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
426460OtherBCBS PIN NO.