Healthcare Provider Details

I. General information

NPI: 1124437405
Provider Name (Legal Business Name): DEBORAH MCGHEE L.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2014
Last Update Date: 08/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 HOSPITAL DR
DOVER OH
44622-2058
US

IV. Provider business mailing address

3515 GUILFORD AVE NW
CANTON OH
44718-3111
US

V. Phone/Fax

Practice location:
  • Phone: 330-343-6631
  • Fax: 330-343-8188
Mailing address:
  • Phone: 330-353-1075
  • Fax: 330-343-8188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.1302751
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: