Individual
DEBRA KAVANAGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
4884 61ST CIR, VERO BEACH, FL 32967-6146
(772) 532-9728
Mailing address
4884 61ST CIR, VERO BEACH, FL 32967-6146
(772) 532-9728
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY6392
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
54859
BLUECROSS
FL
Enumeration date
03/23/2006
Last updated
02/01/2010
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