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General NPI Number Information
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NPI Number | 1659669851
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Entity Type | Organization
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Legal Business Name | DEBORAH L STORY, PSYD, PLLC
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Dates
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Enumeration Date | 07/21/2011
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Last Update Date | 07/21/2011
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Provider Practice Location Address
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Address Line | 508 N MAIN ST
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City | WINTON
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State | NC
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Zip | 27986-9624
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Country | US
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Telephone | 252-358-0144
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Fax | 888-210-4145
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Provider Business Mailing Address
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Address Line | PO BOX B
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City | WINTON
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State | NC
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Zip | 27986-0302
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Country | US
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Telephone | 252-358-0144
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Fax | 888-210-4145
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Authorized Official
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Title or Position | OWNER/PSYCHOLOGIST
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Name | DEBORAH L STORY
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Credential | PSY.D.
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Telephone | 252-358-0144
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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 | 3109
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License Number State | NC
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