Provider Demographics
NPI:1720066004
Name:VINCENT, DEBORAH
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:VINCENT
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:COMDT (CG-1122),
Mailing Address - Street 2:US COAST GUARD, 2100 2ND ST SUITE 5314
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20593-0001
Mailing Address - Country:US
Mailing Address - Phone:757-483-8596
Mailing Address - Fax:757-483-8610
Practice Address - Street 1:COMDT (CG-1122),
Practice Address - Street 2:US COAST GUARD, 2100 2ND ST SUITE 5314
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20593-0001
Practice Address - Country:US
Practice Address - Phone:757-483-8596
Practice Address - Fax:757-483-8610
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other