Provider Demographics
NPI:1699089730
Name:RITTERBUSH, DEBBIE (PHD)
Entity type:Individual
Prefix:DR
First Name:DEBBIE
Middle Name:
Last Name:RITTERBUSH
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 1:914 E GURLEY ST STE 200
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-3245
Mailing Address - Country:US
Mailing Address - Phone:928-458-9140
Mailing Address - Fax:800-948-8058
Practice Address - Street 1:914 E GURLEY ST STE 200
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-3245
Practice Address - Country:US
Practice Address - Phone:928-458-9140
Practice Address - Fax:800-948-8058
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-30
Last Update Date:2019-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-14266101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ116998Medicaid