| Doctor Name: | DEBRA LEE RETZLAFF |
| NPI Number: | 1164508701 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 068990 |
| Business Practice Address: | 89 River Rd # B North Tonawanda, NY - 141205713 |
| Business Phone Number: | 7166939961 |
| Business Fax Number: | |
| Mailing Address: | 2031 Old Coomer Rd, BURT |
| State: | NY |
| Postal Code: | 140289735 |
| Phone Number: | 7167788337 |
| Fax Number: | |
| NPI Enumeration Date: | 10/27/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 068990 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |