Provider Demographics
NPI:1982800918
Name:MOHN, DEBORAH ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:ANN
Last Name:MOHN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 E 13TH ST
Mailing Address - Street 2:SUITE 321
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36201-4601
Mailing Address - Country:US
Mailing Address - Phone:256-310-4695
Mailing Address - Fax:256-235-2431
Practice Address - Street 1:7 E 13TH ST
Practice Address - Street 2:SUITE 321
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36201-4601
Practice Address - Country:US
Practice Address - Phone:256-310-4695
Practice Address - Fax:256-235-2431
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1380103TC0700X, 103TC2200X, 103TB0200X, 103TF0200X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALQ20839Medicare UPIN
AL051557348MOHMedicare PIN