Provider Demographics
NPI:1588254601
Name:BRACKETT, DEBORAH J (OT)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:J
Last Name:BRACKETT
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:J
Other - Last Name:SOUSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:178 FARMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03867-4352
Mailing Address - Country:US
Mailing Address - Phone:603-332-1133
Mailing Address - Fax:603-332-9223
Practice Address - Street 1:178 FARMINGTON RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867-4352
Practice Address - Country:US
Practice Address - Phone:603-332-1133
Practice Address - Fax:603-332-9223
Is Sole Proprietor?:No
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1330225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist