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General NPI Number Information
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NPI Number | 1003866922
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Entity Type | Individual
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Provider Name | DEBRA CHARMAINE VINER PHD
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Gender | Female
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 01/14/2023
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Provider Practice Location Address
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Address Line | 306 W SUPERIOR ST STE 1000
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City | DULUTH
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State | MN
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Zip | 55802-1818
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Country | US
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Telephone | 218-481-7660
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Fax | 218-216-1452
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Provider Business Mailing Address
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Address Line | 306 W SUPERIOR ST STE 1000
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City | DULUTH
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State | MN
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Zip | 55802-1818
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Country | US
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Telephone | 218-428-1175
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Fax | 218-216-1452
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LP1868
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1868
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License Number State | MN
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