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Individual
THERESA JANE DEBORD
Active
Individual
THERESA JANE DEBORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2025011453
MO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2025011453
MO
Other
Enumeration date
07/17/2019
Last updated
09/28/2026
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