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Individual
MICHELLE GUY DEBORD
Active
Individual
MICHELLE GUY DEBORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904006384
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004945298
—
VA
01
—
0904006384
LICENSE
VA
01
—
1316052657
NPI
VA
01
—
13583210
CAQH
VA
Enumeration date
08/19/2006
Last updated
08/27/2015
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