Provider Demographics
NPI:1861161960
Name:FILIZETTI, DEBORAH LANE
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LANE
Last Name:FILIZETTI
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 1:3304 DRUID WAY
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-2926
Mailing Address - Country:US
Mailing Address - Phone:417-434-6263
Mailing Address - Fax:
Practice Address - Street 1:3304 DRUID WAY
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-2926
Practice Address - Country:US
Practice Address - Phone:417-434-6263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20020125841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical