Provider Demographics
NPI:1215355771
Name:SPRING, DEBORA
Entity Type:Individual
Prefix:
First Name:DEBORA
Middle Name:
Last Name:SPRING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 E DUNCAN ST
Mailing Address - Street 2:2B
Mailing Address - City:MANCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48158-8599
Mailing Address - Country:US
Mailing Address - Phone:734-476-2784
Mailing Address - Fax:
Practice Address - Street 1:1005 E DUNCAN ST
Practice Address - Street 2:2B
Practice Address - City:MANCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48158-8599
Practice Address - Country:US
Practice Address - Phone:734-476-2784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-02
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201002354225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist