Provider Demographics
NPI:1427515949
Name:ABNER, DEBORAH R
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:R
Last Name:ABNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3703 STOCKHOLM DR
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30906-9043
Mailing Address - Country:US
Mailing Address - Phone:706-750-5348
Mailing Address - Fax:
Practice Address - Street 1:2357 TOBACCO RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30906-9220
Practice Address - Country:US
Practice Address - Phone:706-722-3855
Practice Address - Fax:706-722-5534
Is Sole Proprietor?:No
Enumeration Date:2019-02-21
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA58231216103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling