Provider Demographics
NPI:1245440908
Name:REUBEN, DEBRA LYNNE (PHD)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:LYNNE
Last Name:REUBEN
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:COND. GALERIA I, SUITE #8, MAILBOX 208
Mailing Address - Street 2:201 AVE. ARTERIAL HOSTOS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-1405
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CONDOMINIO GALERIA I, SUITE 8
Practice Address - Street 2:201 ARTERIAL HOSTOS AVE.
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-287-9446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1254103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical