Provider Demographics
NPI:1902635311
Name:HINMAN, DEBORAH SUE
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:SUE
Last Name:HINMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:SUE
Other - Last Name:KIDD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:937 TAMARACK DR
Mailing Address - Street 2:
Mailing Address - City:WILLARD
Mailing Address - State:OH
Mailing Address - Zip Code:44890-9443
Mailing Address - Country:US
Mailing Address - Phone:567-224-7684
Mailing Address - Fax:
Practice Address - Street 1:725 WESSOR AVE
Practice Address - Street 2:
Practice Address - City:WILLARD
Practice Address - State:OH
Practice Address - Zip Code:44890-9417
Practice Address - Country:US
Practice Address - Phone:567-228-9159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-01
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)