| Doctor Name: | CLAUDIA MARY DEBACKER |
| NPI Number: | 1245353093 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA LIP CACT |
| License Number: | 6301008890 |
| Business Practice Address: | 2 Crocker Blvd Suite 101 Mt Clemens, MI - 480432558 |
| Business Phone Number: | 5864682266 |
| Business Fax Number: | 5864684505 |
| Mailing Address: | 2134 Anita Ave, GROSSE POINTE WOODS |
| State: | MI |
| Postal Code: | 482361430 |
| Phone Number: | 3138819151 |
| Fax Number: | |
| NPI Enumeration Date: | 04/09/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC1900X |
| License Number: | 6301008890 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Counseling |
| Taxonomy Definition: | |