Provider Demographics
NPI:1740845858
Name:DRABNER, DEBRA
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:DRABNER
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 1:164 E 5900 S STE A101
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-7279
Mailing Address - Country:US
Mailing Address - Phone:801-261-5790
Mailing Address - Fax:801-261-5794
Practice Address - Street 1:164 E 5900 S STE A101
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-7279
Practice Address - Country:US
Practice Address - Phone:801-261-5790
Practice Address - Fax:801-261-5794
Is Sole Proprietor?:No
Enumeration Date:2019-05-03
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8077202-3503104100000X
UT8077202-6006101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker