Healthcare Provider Details

I. General information

NPI: 1982926986
Provider Name (Legal Business Name): DEBORAH CHRISTINE PROBST PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2010
Last Update Date: 02/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 BRADY ST
BRADY TX
76825-8601
US

IV. Provider business mailing address

203 BRADY ST
BRADY TX
76825-8601
US

V. Phone/Fax

Practice location:
  • Phone: 325-597-2832
  • Fax: 325-597-2832
Mailing address:
  • Phone: 325-597-2832
  • Fax: 325-597-2832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number11786
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: