Provider Demographics
NPI:1306136254
Name:BJELICA, DEBRA MARIE (MED)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:MARIE
Last Name:BJELICA
Suffix:
Gender:F
Credentials:MED
Other - Prefix:MISS
Other - First Name:DEBRA
Other - Middle Name:MARIE
Other - Last Name:ABDELLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED
Mailing Address - Street 1:11827 RIDGE PKWY
Mailing Address - Street 2:# 718
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-5080
Mailing Address - Country:US
Mailing Address - Phone:720-984-3699
Mailing Address - Fax:
Practice Address - Street 1:8889 FOX DR
Practice Address - Street 2:SUITE B
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80260-8841
Practice Address - Country:US
Practice Address - Phone:720-984-3699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health