Provider Demographics
NPI:1487894341
Name:HANEY, DEBRA O (OT)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:O
Last Name:HANEY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:D
Other - Last Name:OBLANDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:136 CORPORATE PARK DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-6959
Mailing Address - Country:US
Mailing Address - Phone:704-360-2796
Mailing Address - Fax:704-360-7898
Practice Address - Street 1:870 SUMMIT CROSSING PL
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-2192
Practice Address - Country:US
Practice Address - Phone:704-671-1860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-04
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2803225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist