MEDICARE: DEBORAH DAY

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	1041C0700X	Clinical Social Worker	MC15677	ME

General Provider Information

NPI Number	:	1629451802
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH DAY

Provider Business Mailing Address
First Line	:	1268 PORT RD
Second Line	:
City	:	MACHIASPORT
State	:	ME
Zip	:	04655-3315
Country	:	US
Telephone Number	:	207-255-0139
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 KIDS COR
Second Line	:
City	:	MACHIAS
State	:	ME
Zip	:	04654-3328
Country	:	US
Telephone Number	:	207-255-6786
Fax Number	:

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

Provider Enumeration Date	:	07/07/2015
Last Update Date	:	09/27/2015

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Directions to “ DEBORAH DAY ” Practice Location

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