Provider Demographics
NPI:1932753225
Name:NEALE, DEBRA A (CPT)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:A
Last Name:NEALE
Suffix:
Gender:F
Credentials:CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 BEAR HILL RD
Mailing Address - Street 2:
Mailing Address - City:DOVER FOXCROFT
Mailing Address - State:ME
Mailing Address - Zip Code:04426-3217
Mailing Address - Country:US
Mailing Address - Phone:207-266-6852
Mailing Address - Fax:207-276-5655
Practice Address - Street 1:1 KIMBAL ROAD
Practice Address - Street 2:
Practice Address - City:NORTHEAST HARBOR
Practice Address - State:ME
Practice Address - Zip Code:04662
Practice Address - Country:US
Practice Address - Phone:207-276-5039
Practice Address - Fax:207-276-5655
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-25
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1601228665174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator