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General NPI Number Information
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NPI Number | 1689111064
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Entity Type | Organization
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Legal Business Name | DB PERFORMANCE CONSULTING
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Dates
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Enumeration Date | 01/24/2017
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Last Update Date | 01/24/2017
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Provider Practice Location Address
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Address Line | 4611 ROGERS AVE SUITE 103
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City | FORT SMITH
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State | AR
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Zip | 72903-3148
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Country | US
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Telephone | 479-561-7600
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Fax | 479-434-4333
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Provider Business Mailing Address
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Address Line | 4611 ROGERS AVE SUITE 103
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City | FORT SMITH
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State | AR
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Zip | 72903-3148
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Country | US
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Telephone | 479-561-7600
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Fax | 479-434-4333
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | DR. DEBORAH A BRABOY
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Credential | PHD, LPC
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Telephone | 479-561-7600
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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 | P0806053
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License Number State | AR
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