Provider Demographics
NPI:1538203948
Name:O'LAUGHLIN, DEBORAH LEE (PHD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:LEE
Last Name:O'LAUGHLIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:DEBORAH
Other - Middle Name:LEE
Other - Last Name:O'LAUGHLIN-BERNARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:3227 CEITUS PKWY
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991-1083
Mailing Address - Country:US
Mailing Address - Phone:239-283-1918
Mailing Address - Fax:239-283-1921
Practice Address - Street 1:3227 CEITUS PKWY
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33991-1083
Practice Address - Country:US
Practice Address - Phone:239-283-1918
Practice Address - Fax:239-283-1921
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-18
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5954103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL680990196Medicaid
FLR68911Medicare UPIN