Provider Demographics
NPI:1588993448
Name:MCDERMOTT, DEBORAH SUE (PHD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:SUE
Last Name:MCDERMOTT
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 1:4904 CYPRESS LN
Mailing Address - Street 2:
Mailing Address - City:PANORA
Mailing Address - State:IA
Mailing Address - Zip Code:50216-8623
Mailing Address - Country:US
Mailing Address - Phone:641-431-1325
Mailing Address - Fax:
Practice Address - Street 1:309 S 7TH ST
Practice Address - Street 2:SUITE C
Practice Address - City:ADEL
Practice Address - State:IA
Practice Address - Zip Code:50003-1838
Practice Address - Country:US
Practice Address - Phone:641-431-1325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-23
Last Update Date:2010-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001094103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist