Provider Demographics
NPI:1043082290
Name:SHUNNARAH, DEBORAH (ALC)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:SHUNNARAH
Suffix:
Gender:
Credentials:ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 OFFICE PARK DR STE 112
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35223-3409
Mailing Address - Country:US
Mailing Address - Phone:205-202-1143
Mailing Address - Fax:
Practice Address - Street 1:400 OFFICE PARK DR STE 112
Practice Address - Street 2:
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35223-3409
Practice Address - Country:US
Practice Address - Phone:205-202-1143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-23
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALALC04530101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health