MEDICARE: MS. DEBORAH KAY WEIR L.P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	LPC-10612	AZ

General Provider Information

NPI Number	:	1013901149
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBORAH KAY WEIR L.P.C.

Provider Business Mailing Address
First Line	:	5025 N CENTRAL AVE
Second Line	:	PMB 146
City	:	PHOENIX
State	:	AZ
Zip	:	85012-1520
Country	:	US
Telephone Number	:	480-213-1035
Fax Number	:

Provider Business Practice Location Address
First Line	:	6320 E THOMAS RD
Second Line	:	#309
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85251-7077
Country	:	US
Telephone Number	:	480-213-1035
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/05/2005
Last Update Date	:	07/08/2007

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