Provider Demographics
NPI:1114268745
Name:DARDEN, DEBORAH S (LPTA/COTA-L)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:S
Last Name:DARDEN
Suffix:
Gender:F
Credentials:LPTA/COTA-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31011 SMITHS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:VA
Mailing Address - Zip Code:23851-4305
Mailing Address - Country:US
Mailing Address - Phone:757-334-5521
Mailing Address - Fax:
Practice Address - Street 1:31011 SMITHS FERRY RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:VA
Practice Address - Zip Code:23851-4305
Practice Address - Country:US
Practice Address - Phone:757-334-5521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-06
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0131000298224Z00000X
VA2306000918225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant