Provider Demographics
NPI:1194877944
Name:REESE, DEBORAH
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:REESE
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:DEBORAH
Other - Middle Name:JEAN
Other - Last Name:HOWARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1305 N BAY DR
Mailing Address - Street 2:
Mailing Address - City:LYNN HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:32444-3205
Mailing Address - Country:US
Mailing Address - Phone:808-291-3489
Mailing Address - Fax:
Practice Address - Street 1:1305 N BAY DR
Practice Address - Street 2:
Practice Address - City:LYNN HAVEN
Practice Address - State:FL
Practice Address - Zip Code:32444-3205
Practice Address - Country:US
Practice Address - Phone:808-291-3489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL371862251P0200X, 225100000X
HI3693225100000X
NM1454225100000X, 2251P0200X
VA23052051872251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist