Provider Demographics
NPI:1992082911
Name:UNNASCH, DEANNA LEE (LMBT)
Entity type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:LEE
Last Name:UNNASCH
Suffix:
Gender:F
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 STRONG RD
Mailing Address - Street 2:
Mailing Address - City:BESSEMER CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28016-6718
Mailing Address - Country:US
Mailing Address - Phone:704-718-0438
Mailing Address - Fax:
Practice Address - Street 1:105 REGAL DR
Practice Address - Street 2:SUITE 3
Practice Address - City:KINGS MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28086-3466
Practice Address - Country:US
Practice Address - Phone:704-718-0438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6805225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist