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NPI Code Detail

MEDICARE: DEBRA ANN DECEMBLY

MEDICARE: DEBRA ANN DECEMBLY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorCDCA.183028OH

General Provider Information

NPI Number : 1639884976
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBRA ANN DECEMBLY
Provider Business Mailing Address
First Line : 80 E MIDLOTHIAN BLVD
Second Line :
City : YOUNGSTOWN
State : OH
Zip : 44507-2019
Country : US
Telephone Number : 330-234-5251
Fax Number :
Provider Business Practice Location Address
First Line : 80 E MIDLOTHIAN BLVD
Second Line :
City : YOUNGSTOWN
State : OH
Zip : 44507-2019
Country : US
Telephone Number : 330-234-5251
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2023
Last Update Date : 01/20/2023

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Directions to “ DEBRA ANN DECEMBLY ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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