Provider Demographics
NPI:1447363684
Name:RASOULIYAN, DEBRA D (LPC)
Entity type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:D
Last Name:RASOULIYAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:315 W PONCE DE LEON AVE
Mailing Address - Street 2:SUITE 565
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-2400
Mailing Address - Country:US
Mailing Address - Phone:678-438-5665
Mailing Address - Fax:770-808-5302
Practice Address - Street 1:315 W PONCE DE LEON AVE
Practice Address - Street 2:SUITE 565
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-2400
Practice Address - Country:US
Practice Address - Phone:678-438-5665
Practice Address - Fax:770-808-5302
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA003648101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional