MEDICARE: DR. DEBRA ANNE COHEN PH.D.

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	104100000X	Social Worker	R043698-1	NY
2	1041C0700X	Clinical Social Worker	SW7146	FL

General Provider Information

NPI Number	:	1639311574
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBRA ANNE COHEN PH.D.

Provider Business Mailing Address
First Line	:	9153 PICOT CT
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33472-2468
Country	:	US
Telephone Number	:	561-732-8543
Fax Number	:	561-738-0465

Provider Business Practice Location Address
First Line	:	9153 PICOT CT
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33472-2468
Country	:	US
Telephone Number	:	561-732-8543
Fax Number	:	561-738-0465

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

Provider Enumeration Date	:	03/24/2009
Last Update Date	:	03/24/2009

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