Provider Demographics
NPI:1528105186
Name:CARRIERE, DEBRA (PHD)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:CARRIERE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 SW MONROE AVE
Mailing Address - Street 2:SUITE 210F
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97333-7202
Mailing Address - Country:US
Mailing Address - Phone:541-754-0070
Mailing Address - Fax:
Practice Address - Street 1:408 SW MONROE AVE
Practice Address - Street 2:SUITE M210F
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97333-7210
Practice Address - Country:US
Practice Address - Phone:541-754-0070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC1275101YP2500X
OR2136103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional