| Doctor Name: | RONALD OWEN DEBORD |
| NPI Number: | 1851614564 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW |
| License Number: | LSW5190 |
| Business Practice Address: | 4330 Maynardville Hwy Maynardville, TN - 378073618 |
| Business Phone Number: | 8659923849 |
| Business Fax Number: | 8659925166 |
| Mailing Address: | Dept 888182, KNOXVILLE |
| State: | TN |
| Postal Code: | 379958182 |
| Phone Number: | 8003553565 |
| Fax Number: | 4237142355 |
| NPI Enumeration Date: | 03/09/2010 |
| NPI Last Update Date: | 03/09/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | LSW5190 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |