Provider Demographics
NPI:1043288905
Name:MCNALLY, DEBORAH (OT)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:
Last Name:MCNALLY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 E COURT ST STE 202A
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2870
Mailing Address - Country:US
Mailing Address - Phone:864-483-6963
Mailing Address - Fax:
Practice Address - Street 1:25 E COURT ST STE 202A
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-2870
Practice Address - Country:US
Practice Address - Phone:864-483-6963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2285225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC2285OtherOT LICENSE