Provider Demographics
NPI:1487975686
Name:DEATON, PATTI BURRIS (COTA)
Entity type:Individual
Prefix:MRS
First Name:PATTI
Middle Name:BURRIS
Last Name:DEATON
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
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Mailing Address - Street 1:1805 PARKS LAFFERTY RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-1256
Mailing Address - Country:US
Mailing Address - Phone:704-795-5519
Mailing Address - Fax:704-364-2485
Practice Address - Street 1:5114 PROVIDENCE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-5852
Practice Address - Country:US
Practice Address - Phone:704-364-2485
Practice Address - Fax:704-364-2485
Is Sole Proprietor?:No
Enumeration Date:2010-06-22
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3085224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant