Debra Japzon Gillum in Fayetteville - Clinical
Debra Japzon Gillum - NPI 1649365503
Debra Japzon Gillum is a Clinical in Fayetteville, North Carolina. Debra Japzon Gillum practices all healthcare services and medical treatments related to Clinical. The NPI Number for Debra Japzon Gillum is 1649365503. The last update date is 2009-06-22.
Debra Japzon Gillum's current location address is 1540 Purdue Dr, Fayetteville, North Carolina. You can contact this provider via phone number 9018678889 and fax number 9018678699. The mailing address for Debra Japzon Gillum is 1540 Purdue Dr, Fayetteville, North Carolina. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Debra Japzon Gillum |
|---|---|
| Address | 1540 Purdue Dr, Fayetteville, North Carolina |
| Phone Number | 9018678889 |
| Fax Number | 9018678699 |
| Sole Proprietor | Y |
| Credentials | PH.D. |
NPI Number Detail
| NPI Number | 1649365503 |
|---|---|
| Provider Enumeration Date | 2006-10-04 |
| Last Updated Date | 2009-06-22 |
Provider Mailing Address Detail
| Address | 1540 Purdue Dr |
|---|---|
| City | Fayetteville |
| State | North Carolina (NC) |
| Post Code | 283035510 |
| Phone Number | 9018678889 |
| Fax Number | 9018678699 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 1708 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 6000388 | NC | -- | |
| 0450T | NC | BCBS |
Post Comment/ Review Below
What is the unique identification code assigned to Debra Japzon Gillum by the Centers for Medicare & Medicaid Services?
The Debra Japzon Gillum has been issued the NPI (National Provider Identifier) 1649365503. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Debra Japzon Gillum is physically located?
The Debra Japzon Gillum is situated at the following address: 1540 Purdue Dr, Fayetteville, NC 283035510.
What is Debra Japzon Gillum's specialized field of practice, and what is the corresponding taxonomy classification code?
The Debra Japzon Gillum's area of specialization is Clinical, and the corresponding taxonomy code that categorizes this field of practice is 103Tc0700X.
When did the Debra Japzon Gillum receive its 1649365503?
The Debra Japzon Gillum was issued its 1649365503 on 2006-10-04, which is the date when the organization was assigned this unique identifier.
When was the information pertaining to Debra Japzon Gillum most recently updated or revised?
The details related to Debra Japzon Gillum, including its address, specialty, and other relevant information, were last updated or revised on 2009-06-22.
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