Provider Demographics
NPI:1215103981
Name:MEYERSON, DEBORAH R (MAED/MSW)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:R
Last Name:MEYERSON
Suffix:
Gender:F
Credentials:MAED/MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 DEMUN AVE
Mailing Address - Street 2:
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63105
Mailing Address - Country:US
Mailing Address - Phone:314-721-5717
Mailing Address - Fax:314-721-3271
Practice Address - Street 1:929 DEMUN AVE
Practice Address - Street 2:929 DEMUN AVE
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63105
Practice Address - Country:US
Practice Address - Phone:314-721-5717
Practice Address - Fax:314-721-3271
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-02
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMO SW 0014581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical