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NPI Code Detail

MEDICARE: MRS. DEBBIE J AUTREY MA

MEDICARE: MRS. DEBBIE J AUTREY MA
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
1101YM0800XMental Health Counselor9-0-31EAR

General Provider Information

NPI Number : 1790754018
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DEBBIE J AUTREY MA
Provider Business Mailing Address
First Line : 701 ARKANSAS BLVD
Second Line :
City : TEXARKANA
State : AR
Zip : 71854-2105
Country : US
Telephone Number : 870-772-5028
Fax Number : 870-772-5056
Provider Business Practice Location Address
First Line : 701 ARKANSAS BLVD
Second Line :
City : TEXARKANA
State : AR
Zip : 71854-2105
Country : US
Telephone Number : 870-772-5028
Fax Number : 870-772-5056
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2006
Last Update Date : 08/04/2008

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Directions to “ MRS. DEBBIE J AUTREY MA” Practice Location

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