Provider Demographics
NPI:1487751061
Name:GREENING, DEBORAH ELAINE (PHD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:ELAINE
Last Name:GREENING
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3757 WARWICK DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314-2803
Mailing Address - Country:US
Mailing Address - Phone:586-997-9722
Mailing Address - Fax:248-213-0521
Practice Address - Street 1:29201 TELEGRAPH RD
Practice Address - Street 2:SUITE 550
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1331
Practice Address - Country:US
Practice Address - Phone:248-213-0501
Practice Address - Fax:248-213-0521
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI6301008082103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P28490Medicare ID - Type Unspecified