Provider Demographics
NPI:1063666469
Name:DOUTHIT, DEBRA (MA, LMFT)
Entity type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:
Last Name:DOUTHIT
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 STINARD AVE
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13207-1239
Mailing Address - Country:US
Mailing Address - Phone:315-478-0083
Mailing Address - Fax:
Practice Address - Street 1:120 STINARD AVE
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13207-1239
Practice Address - Country:US
Practice Address - Phone:315-478-0083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-12
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00090106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist