Provider Demographics
NPI:1104990936
Name:DANIELS MOHRING, DEBBIE (PHD)
Entity type:Individual
Prefix:DR
First Name:DEBBIE
Middle Name:
Last Name:DANIELS MOHRING
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:DEBBIE
Other - Middle Name:
Other - Last Name:MOHRING BRAGGA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2200 PUMP RD
Mailing Address - Street 2:STE 220
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23233-3539
Mailing Address - Country:US
Mailing Address - Phone:804-740-0681
Mailing Address - Fax:804-740-4651
Practice Address - Street 1:2200 PUMP RD
Practice Address - Street 2:STE 220
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23233-3539
Practice Address - Country:US
Practice Address - Phone:804-740-0681
Practice Address - Fax:804-740-4651
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001554103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
11510894OtherCAQM
680000751Medicare ID - Type Unspecified