Provider Demographics
NPI:1700105335
Name:MCCOMB, DEBBIE K
Entity Type:Individual
Prefix:MS
First Name:DEBBIE
Middle Name:K
Last Name:MCCOMB
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:PO BOX 1476
Mailing Address - Street 2:
Mailing Address - City:ATOKA
Mailing Address - State:OK
Mailing Address - Zip Code:74525-6476
Mailing Address - Country:US
Mailing Address - Phone:580-889-6053
Mailing Address - Fax:866-205-1440
Practice Address - Street 1:1501 S VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:ATOKA
Practice Address - State:OK
Practice Address - Zip Code:74525-3233
Practice Address - Country:US
Practice Address - Phone:580-889-6053
Practice Address - Fax:866-205-1440
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-21
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor