Provider Demographics
NPI:1881240786
Name:DEBETS, MEGAN
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:DEBETS
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 1:11792 W PINEWOOD RIVER LN
Mailing Address - Street 2:
Mailing Address - City:STAR
Mailing Address - State:ID
Mailing Address - Zip Code:83669-5984
Mailing Address - Country:US
Mailing Address - Phone:626-244-4822
Mailing Address - Fax:
Practice Address - Street 1:3235 E OVERLAND RD
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-6711
Practice Address - Country:US
Practice Address - Phone:888-701-1388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-15
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID1-24-76055103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst