Provider Demographics
NPI:1154561934
Name:DARNELL, DEBORAH MARIE (MA)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:MARIE
Last Name:DARNELL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 BISHOP RD SW
Mailing Address - Street 2:SUITE 105
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98512-7303
Mailing Address - Country:US
Mailing Address - Phone:360-880-4032
Mailing Address - Fax:360-878-9506
Practice Address - Street 1:1610 BISHOP RD SW
Practice Address - Street 2:SUITE 105
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98512-7303
Practice Address - Country:US
Practice Address - Phone:360-880-4032
Practice Address - Fax:360-878-9506
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-06
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00009533101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health