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Individual

DEBRA TREMBLAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LSCSW, LMTF

Contact information

Practice address
124 E 12TH ST, HAYS, KS 67601-3608
(785) 628-3575
(785) 621-2257
Mailing address
124 E 12TH ST, HAYS, KS 67601-3608
(785) 628-3575
(785) 621-2257

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
459
KS
1041C0700X
Clinical Social Worker
Primary
1478
KS
106H00000X
Marriage & Family Therapist
0292
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3063
KS
05
3306
KS
01
9094660627
BLUECROSS AND BLUE SHIELD OF KS
KS
05
9660627940
KS
Enumeration date
01/20/2014
Last updated
01/20/2014
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