Healthcare Provider Details

I. General information

NPI: 1841329265
Provider Name (Legal Business Name): DEBRA SUE OBROCK M.E.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

332 SUMNER HALL DR
GALLATIN TN
37066-3129
US

IV. Provider business mailing address

122 CHESAPEAKE HARBOR BLVD
HENDERSONVILLE TN
37075-4732
US

V. Phone/Fax

Practice location:
  • Phone: 615-460-4519
  • Fax: 615-460-4502
Mailing address:
  • Phone: 615-826-7459
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: