Provider Demographics
NPI:1447620224
Name:LANEY, DEBORAH S
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:S
Last Name:LANEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 464
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-0464
Mailing Address - Country:US
Mailing Address - Phone:513-652-7451
Mailing Address - Fax:513-444-4753
Practice Address - Street 1:6215 WATCHCREEK WAY APT 103
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-5611
Practice Address - Country:US
Practice Address - Phone:513-652-7451
Practice Address - Fax:513-444-4753
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-06
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor