Provider Demographics
NPI:1447489596
Name:KALNEN, DEBORAH ANN (MA, L P A)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
Last Name:KALNEN
Suffix:
Gender:F
Credentials:MA, L P A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 SCOTTS HILL LOOP RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411-6626
Mailing Address - Country:US
Mailing Address - Phone:910-443-3288
Mailing Address - Fax:
Practice Address - Street 1:1703 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-6008
Practice Address - Country:US
Practice Address - Phone:910-347-3010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-10
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3776103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist