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General NPI Number Information
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NPI Number | 1033623475
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Entity Type | Individual
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Provider Name | DEBORAH VAIL MA, LPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 11/21/2017
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Last Update Date | 03/15/2023
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Provider Practice Location Address
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Address Line | 300 FORT ZUMWALT SQ STE 121
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City | O FALLON
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State | MO
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Zip | 63366-3078
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Country | US
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Telephone | 636-626-4300
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Fax | 719-487-3251
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Provider Business Mailing Address
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Address Line | 300 FORT ZUMWALT SQ STE 121
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City | O FALLON
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State | MO
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Zip | 63366-3078
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Country | US
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Telephone | 636-626-4300
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Fax | 719-487-3251
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2023007976
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC.0017424
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License Number State | CO
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