Healthcare Provider Details

I. General information

NPI: 1053613901
Provider Name (Legal Business Name): DEBRA FILETA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2010
Last Update Date: 11/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1849 S FORGE RD
PALMYRA PA
17078-9108
US

IV. Provider business mailing address

2227 OLD EMMORTON RD SUITE 119
BEL AIR MD
21015-6187
US

V. Phone/Fax

Practice location:
  • Phone: 410-893-4600
  • Fax: 410-569-0094
Mailing address:
  • Phone: 410-893-4600
  • Fax: 410-569-0094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC005662
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: