Provider Demographics
NPI:1801057195
Name:DAY, DEBRA G (M ED)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:G
Last Name:DAY
Suffix:
Gender:F
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 BUSH CV
Mailing Address - Street 2:
Mailing Address - City:BASTROP
Mailing Address - State:TX
Mailing Address - Zip Code:78602-2400
Mailing Address - Country:US
Mailing Address - Phone:512-718-4733
Mailing Address - Fax:
Practice Address - Street 1:103 BUSH CV
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:TX
Practice Address - Zip Code:78602-2400
Practice Address - Country:US
Practice Address - Phone:512-718-4733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-19
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11768101YP2500X
TX3378106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist