Healthcare Provider Details

I. General information

NPI: 1588792766
Provider Name (Legal Business Name): MRS. DEBORA YEMANE-GHAIM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 8TH AVE N
NASHVILLE TN
37208-2621
US

IV. Provider business mailing address

656 FLINTLOCK CT
NASHVILLE TN
37217-3616
US

V. Phone/Fax

Practice location:
  • Phone: 615-460-4109
  • Fax:
Mailing address:
  • Phone: 615-268-8331
  • 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: