Provider Demographics
NPI:1447682323
Name:HOPPER, DEBRA LYNN (NCMTB)
Entity type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:LYNN
Last Name:HOPPER
Suffix:
Gender:F
Credentials:NCMTB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5998 RUNNYMEADE DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-2838
Mailing Address - Country:US
Mailing Address - Phone:734-355-6656
Mailing Address - Fax:
Practice Address - Street 1:650 CHURCH ST RM 202
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-1689
Practice Address - Country:US
Practice Address - Phone:734-416-5200
Practice Address - Fax:734-416-1127
Is Sole Proprietor?:No
Enumeration Date:2013-08-02
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225700000X
MI106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist