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NPI Code Detail

MEDICARE: MRS. DEBRA GRACE STEWART RAS

MEDICARE: MRS. DEBRA GRACE STEWART RAS
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
1101YA0400XAddiction (Substance Use Disorder) CounselorS0402241230CA

General Provider Information

NPI Number : 1063509834
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DEBRA GRACE STEWART RAS
Provider Business Mailing Address
First Line : 2276 DIXON LN
Second Line :
City : BISHOP
State : CA
Zip : 93514-8094
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1290 TAVERN RD STE 276
Second Line :
City : MAMMOTH LAKES
State : CA
Zip : 93546-6601
Country : US
Telephone Number : 760-924-1740
Fax Number : 760-924-1741
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2006
Last Update Date : 05/21/2024

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