Provider Demographics
NPI:1639311574
Name:COHEN, DEBRA ANNE (PHD)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:ANNE
Last Name:COHEN
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 1:9153 PICOT CT
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33472-2468
Mailing Address - Country:US
Mailing Address - Phone:561-732-8543
Mailing Address - Fax:561-738-0465
Practice Address - Street 1:9153 PICOT CT
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33472-2468
Practice Address - Country:US
Practice Address - Phone:561-732-8543
Practice Address - Fax:561-738-0465
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-24
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR043698-1104100000X
FLSW71461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker