Provider Demographics
NPI:1063548253
Name:LAVIN, DEBRA REDMAN (EDD)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:REDMAN
Last Name:LAVIN
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 ANNE CHAMBERS LN
Mailing Address - Street 2:
Mailing Address - City:KATONAH
Mailing Address - State:NY
Mailing Address - Zip Code:10536-3406
Mailing Address - Country:US
Mailing Address - Phone:914-232-0756
Mailing Address - Fax:
Practice Address - Street 1:20 ANNE CHAMBERS LN
Practice Address - Street 2:
Practice Address - City:KATONAH
Practice Address - State:NY
Practice Address - Zip Code:10536-3406
Practice Address - Country:US
Practice Address - Phone:914-232-0756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-24
Last Update Date:2018-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006671-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical