Provider Demographics
NPI:1992025977
Name:ROSS, DEBORAH SHAY (COTA)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:SHAY
Last Name:ROSS
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1001 MIDDLEFORD RD
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973-3638
Mailing Address - Country:US
Mailing Address - Phone:302-628-5608
Mailing Address - Fax:302-628-5651
Practice Address - Street 1:1001 MIDDLEFORD RD
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-3638
Practice Address - Country:US
Practice Address - Phone:302-628-5608
Practice Address - Fax:302-628-5651
Is Sole Proprietor?:No
Enumeration Date:2010-06-02
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEU2-0001066224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant