Provider Demographics
NPI:1306095369
Name:MARSHALL, DEBORAH L (LOT)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:L
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:LOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 NIGHTINGALE DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-5101
Mailing Address - Country:US
Mailing Address - Phone:512-940-0414
Mailing Address - Fax:
Practice Address - Street 1:1303 LORRAIN ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-4020
Practice Address - Country:US
Practice Address - Phone:512-472-6080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-15
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX005177225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist