Provider Demographics
NPI:1346246899
Name:JONES, DEB L (OTR L)
Entity Type:Individual
Prefix:MRS
First Name:DEB
Middle Name:L
Last Name:JONES
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 1:1337 GUSDORF RD
Mailing Address - Street 2:STE G
Mailing Address - City:TAOS
Mailing Address - State:NM
Mailing Address - Zip Code:87571-6297
Mailing Address - Country:US
Mailing Address - Phone:575-758-4337
Mailing Address - Fax:575-751-1890
Practice Address - Street 1:1337 GUSDORF RD
Practice Address - Street 2:STE G
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571-6297
Practice Address - Country:US
Practice Address - Phone:575-758-4337
Practice Address - Fax:575-751-1890
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM888225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM10015013OtherLOVELACE HEALTH PLAN PROV
NM0368860OtherCIGNA PROV #
NMNM00N647OtherBLUECROSS PROV #
NM201079915OtherPRESBYTERIAN PROVIDER #
NM68973276Medicaid
NMB4412Medicaid
NMB4412Medicaid