Provider Demographics
NPI:1285888008
Name:BEAUMONT-CARTER, DEBORAH (OTR)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:BEAUMONT-CARTER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8150 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:COMMERCE TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48382-3535
Mailing Address - Country:US
Mailing Address - Phone:248-303-1756
Mailing Address - Fax:
Practice Address - Street 1:8150 GROVE ST
Practice Address - Street 2:
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48382-3535
Practice Address - Country:US
Practice Address - Phone:248-303-1756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-06
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201004336225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist