Provider Demographics
NPI:1730575804
Name:DEBORAH A GREGOR
Entity type:Organization
Organization Name:DEBORAH A GREGOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:GREGOR
Authorized Official - Suffix:
Authorized Official - Credentials:LMFTA, RN
Authorized Official - Phone:980-272-8680
Mailing Address - Street 1:3822 ABINGDON RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-3749
Mailing Address - Country:US
Mailing Address - Phone:704-910-1483
Mailing Address - Fax:704-910-1483
Practice Address - Street 1:4726 PARK RD STE B
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-3375
Practice Address - Country:US
Practice Address - Phone:980-272-8680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-15
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9058A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty