Provider Demographics
NPI:1235694860
Name:PERKINS, PHOEBE (COTA/L)
Entity Type:Individual
Prefix:
First Name:PHOEBE
Middle Name:
Last Name:PERKINS
Suffix:
Gender:F
Credentials: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:PO BOX 5704
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-0704
Mailing Address - Country:US
Mailing Address - Phone:302-478-0600
Mailing Address - Fax:302-478-8545
Practice Address - Street 1:4321 LANCASTER PIKE BLDG 23A
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-1521
Practice Address - Country:US
Practice Address - Phone:302-478-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-07
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEU20001928224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant