Provider Demographics
NPI:1285767186
Name:WOLOSKI, DEBORAH COHEN (LPC, PA-C)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:COHEN
Last Name:WOLOSKI
Suffix:
Gender:F
Credentials:LPC, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 FRIO ST
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-7455
Mailing Address - Country:US
Mailing Address - Phone:956-519-7493
Mailing Address - Fax:
Practice Address - Street 1:800 E ALTON GLOOR BLVD
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-4248
Practice Address - Country:US
Practice Address - Phone:956-518-7444
Practice Address - Fax:956-518-7353
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17615101YP2500X
TXPA06231363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX151342601Medicaid