Provider Demographics
NPI:1982389136
Name:VANCE, DEBORAH ABIGAIL
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ABIGAIL
Last Name:VANCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:ABIGAIL
Other - Last Name:WHITEHEAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2301 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:NC
Mailing Address - Zip Code:28752-2768
Mailing Address - Country:US
Mailing Address - Phone:828-655-6132
Mailing Address - Fax:
Practice Address - Street 1:2301 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:NC
Practice Address - Zip Code:28752-2768
Practice Address - Country:US
Practice Address - Phone:828-655-6132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-15
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician