Provider Demographics
NPI:1215039706
Name:BIRD, DEBORAH O'CONNOR (PH D)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:O'CONNOR
Last Name:BIRD
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3800 STILLMAN PKWY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233-1455
Mailing Address - Country:US
Mailing Address - Phone:804-346-9866
Mailing Address - Fax:804-346-9876
Practice Address - Street 1:3800 STILLMAN PKWY
Practice Address - Street 2:SUITE 201
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-1455
Practice Address - Country:US
Practice Address - Phone:804-346-9866
Practice Address - Fax:804-346-9876
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-04
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001395103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical