| Deborah M. Thevenin, Ph.d., Llc | |
|
7685 Sw 104th St Suite 100 Miami FL 33156-3161 | |
| (305) 666-8000 | |
| (305) 666-4311 |
| Full Name | Deborah M. Thevenin, Ph.d., Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 7685 Sw 104th St, Miami, Florida |
| Authorized Official Name and Position | Deborah Morrison Thevenin (MANAGING MEMBER) |
| Authorized Official Contact | 3054957603 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Deborah M. Thevenin, Ph.d., Llc 1500 Bay Rd Unit 716 South Miami Beach FL 33139-3252 Ph: (305) 495-7603 | Deborah M. Thevenin, Ph.d., Llc 7685 Sw 104th St Suite 100 Miami FL 33156-3161 Ph: (305) 666-8000 |
| NPI Number | 1003228032 |
|---|---|
| Provider Enumeration Date | 05/26/2014 |
| Last Update Date | 05/26/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003228032 | NPI | - | NPPES |
| 1376846295 | Other | FL | NPI TYPE 1 |
| FLPY4442 | Other | FL | FLORIDA STATE PSYCHOLOGIST LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY4442 (Florida) | Primary |
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