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General NPI Number Information
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NPI Number | 1487016911
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Entity Type | Individual
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Provider Name | DEBORAH MARCUS STAYMAN LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/23/2016
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Last Update Date | 04/15/2016
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Provider Practice Location Address
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Address Line | 4330 N HILLS DR
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City | HOLLYWOOD
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State | FL
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Zip | 33021-1804
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Country | US
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Telephone | 305-902-7662
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Fax | 954-986-1281
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Provider Business Mailing Address
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Address Line | 4330 N HILLS DR
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City | HOLLYWOOD
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State | FL
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Zip | 33021-1804
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Country | US
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Telephone | 305-902-7662
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Fax | 954-986-1281
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW12859
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License Number State | FL
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