Provider Demographics
NPI:1982876538
Name:TUFTS, DEBRA LYN (MA, EDS, LLP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:LYN
Last Name:TUFTS
Suffix:
Gender:F
Credentials:MA, EDS, LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1148 4TH ST
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49441-1921
Mailing Address - Country:US
Mailing Address - Phone:231-726-2299
Mailing Address - Fax:231-728-6345
Practice Address - Street 1:1148 4TH ST
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49441-1921
Practice Address - Country:US
Practice Address - Phone:231-726-2299
Practice Address - Fax:231-728-6345
Is Sole Proprietor?:No
Enumeration Date:2008-03-24
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301008825103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist