Provider Demographics
NPI:1780393249
Name:WEBB, DEBRA (MSED)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:WEBB
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 2ND STREET
Mailing Address - Street 2:SUITE E509
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501
Mailing Address - Country:US
Mailing Address - Phone:718-866-4569
Mailing Address - Fax:
Practice Address - Street 1:199 2ND ST APT E509
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-6002
Practice Address - Country:US
Practice Address - Phone:718-866-4569
Practice Address - Fax:718-223-4437
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-23
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst