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General NPI Number Information
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NPI Number | 1851640148
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Entity Type | Individual
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Provider Name | DEBRA SHEPARD NELSON PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 09/03/2012
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Last Update Date | 09/03/2013
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Provider Practice Location Address
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Address Line | 199 MAIN STREET
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City | DURHAM
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State | CT
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Zip | 06422-0002
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Country | US
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Telephone | 860-788-3231
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Fax | 888-844-4036
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Provider Business Mailing Address
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Address Line | PO BOX 2
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City | DURHAM
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State | CT
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Zip | 06422-0002
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Country | US
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Telephone | 860-788-3231
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Fax | 888-844-4036
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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 | 003123
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License Number State | CT
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