Provider Demographics
NPI:1295820819
Name:MCINTOSH, DEBRA RUTH (OTR L)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:RUTH
Last Name:MCINTOSH
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 1:1741 HWY 399
Mailing Address - Street 2:
Mailing Address - City:BEATTYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41311
Mailing Address - Country:US
Mailing Address - Phone:606-464-9633
Mailing Address - Fax:606-464-9633
Practice Address - Street 1:1741 HWY 399
Practice Address - Street 2:
Practice Address - City:BEATTYVILLE
Practice Address - State:KY
Practice Address - Zip Code:41311
Practice Address - Country:US
Practice Address - Phone:606-464-9633
Practice Address - Fax:606-464-9633
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-R0835225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY617OtherFIRST STEPS PROVIDER