Provider Demographics
NPI:1215377270
Name:VATTIMO, DEBRA (LPC)
Entity type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:
Last Name:VATTIMO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 WEST COMMERCIAL SUITE B1
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72216
Mailing Address - Country:US
Mailing Address - Phone:501-218-6193
Mailing Address - Fax:
Practice Address - Street 1:4700 WEST COMMERCIAL SUITE B1
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72216
Practice Address - Country:US
Practice Address - Phone:501-218-6193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-04
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1307076101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional