Provider Demographics
NPI:1316518517
Name:NUTT, DEBORAH M (LAPC)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:M
Last Name:NUTT
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 CANOPY DR
Mailing Address - Street 2:
Mailing Address - City:EAST POINT
Mailing Address - State:GA
Mailing Address - Zip Code:30344-1730
Mailing Address - Country:US
Mailing Address - Phone:404-202-6472
Mailing Address - Fax:
Practice Address - Street 1:1410 CANOPY DR
Practice Address - Street 2:
Practice Address - City:EAST POINT
Practice Address - State:GA
Practice Address - Zip Code:30344-1730
Practice Address - Country:US
Practice Address - Phone:404-202-6472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC007643101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional