Provider Demographics
NPI:1306965637
Name:SMITH, DEBRA ANNE (OTR/L)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:ANNE
Last Name:SMITH
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3036 VIA ESPERANZA
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-8913
Mailing Address - Country:US
Mailing Address - Phone:908-797-4350
Mailing Address - Fax:
Practice Address - Street 1:290 RED SCHOOL LN
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-2276
Practice Address - Country:US
Practice Address - Phone:908-859-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5805225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist