Provider Demographics
NPI:1225383086
Name:JELINEK, DEBORAH D (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:D
Last Name:JELINEK
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 W 21ST ST
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:NE
Mailing Address - Zip Code:69301-2104
Mailing Address - Country:US
Mailing Address - Phone:308-631-3982
Mailing Address - Fax:
Practice Address - Street 1:178 W 21ST ST
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:NE
Practice Address - Zip Code:69301-2104
Practice Address - Country:US
Practice Address - Phone:308-631-3982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE855225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist