Provider Demographics
NPI:1871954834
Name:WYAND, DEBORAH ANN (MED)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:ANN
Last Name:WYAND
Suffix:
Gender:F
Credentials:MED
Other - Prefix:MISS
Other - First Name:DEBBIE
Other - Middle Name:ANN
Other - Last Name:BOUDREAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19 PLEASANT ST
Mailing Address - Street 2:PO BOX 245
Mailing Address - City:HUNTINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01050-9758
Mailing Address - Country:US
Mailing Address - Phone:413-667-0131
Mailing Address - Fax:
Practice Address - Street 1:19 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:MA
Practice Address - Zip Code:01050-9758
Practice Address - Country:US
Practice Address - Phone:413-667-0131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-17
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst