Healthcare Provider Details

I. General information

NPI: 1801127113
Provider Name (Legal Business Name): DEBRA ABARI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2010
Last Update Date: 01/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8603 E EASTRIDGE RD STE A
PRESCOTT VALLEY AZ
86314-8562
US

IV. Provider business mailing address

4549 E BROKEN SADDLE DR
COTTONWOOD AZ
86326-5723
US

V. Phone/Fax

Practice location:
  • Phone: 928-443-5883
  • Fax: 928-717-1660
Mailing address:
  • Phone: 928-821-3085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1195823
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: