Doctor Name: | JEANNINE DENIECE DEAVILLE |
NPI Number: | 1952710352 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 4909 S Coast Hwy Ste 1 South Beach, OR - 973669667 |
Business Phone Number: | 5415745960 |
Business Fax Number: | 5412650601 |
Mailing Address: | 36 Sw Nye St, NEWPORT |
State: | OR |
Postal Code: | 973653821 |
Phone Number: | 5412650581 |
Fax Number: | 5415746252 |
NPI Enumeration Date: | 08/11/2014 |
NPI Last Update Date: | 08/11/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |