Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1215429212 |
---|---|
Provider Name | Dr. Debra Deanes |
First Address | Southfield, MI 48076 |
Second Address | Southfield, MI 48076 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2018 |
Last Update Date | 05/06/2018 |