Provider Demographics
NPI:1992232532
Name:DECKER, DARCELLE CROOKE (OTR)
Entity type:Individual
Prefix:MRS
First Name:DARCELLE
Middle Name:CROOKE
Last Name:DECKER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:DARCELLE
Other - Middle Name:FRANCES
Other - Last Name:CROOKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:112 N ARDMOOR AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17821-1212
Mailing Address - Country:US
Mailing Address - Phone:570-275-7545
Mailing Address - Fax:
Practice Address - Street 1:480 CENTRAL RD
Practice Address - Street 2:
Practice Address - City:BLOOMSBURG
Practice Address - State:PA
Practice Address - Zip Code:17815-3121
Practice Address - Country:US
Practice Address - Phone:570-387-6150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-14
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC-002426-L225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand