MEDICARE: DB PERFORMANCE CONSULTING

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	P0806053	AR

General Provider Information

NPI Number	:	1689111064
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DB PERFORMANCE CONSULTING

Provider Business Mailing Address
First Line	:	4611 ROGERS AVE
Second Line	:	SUITE 103
City	:	FORT SMITH
State	:	AR
Zip	:	72903-3148
Country	:	US
Telephone Number	:	479-561-7600
Fax Number	:	479-434-4333

Provider Business Practice Location Address
First Line	:	4611 ROGERS AVE
Second Line	:	SUITE 103
City	:	FORT SMITH
State	:	AR
Zip	:	72903-3148
Country	:	US
Telephone Number	:	479-561-7600
Fax Number	:	479-434-4333

Authorized Official
Title or Position	:	LICENSED PROFESSIONAL COUNSELOR
Name	:	DR. DEBORAH A BRABOY
Credential	:	PHD, LPC
Telephone Number	:	479-561-7600

Provider Enumeration Date	:	01/24/2017
Last Update Date	:	01/24/2017

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