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General NPI Number Information
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NPI Number | 1376846295
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Entity Type | Individual
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Provider Name | DEBORAH MORRISON THEVENIN PH.D.
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Gender | Female
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Dates
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Enumeration Date | 12/15/2010
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Last Update Date | 12/15/2010
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Provider Practice Location Address
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Address Line | 7685 SW 104TH ST SUITE 100
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City | MIAMI
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State | FL
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Zip | 33156-3161
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Country | US
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Telephone | 305-666-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 BAY RD UNIT 716 SOUTH
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City | MIAMI BEACH
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State | FL
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Zip | 33139-3252
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Country | US
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Telephone | 305-495-7603
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Fax |
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY4442
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103TH0004X
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Taxonomy Name | Health Psychologist
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License Number | PSY4442
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License Number State | FL
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