Provider Demographics
NPI:1376918995
Name:BLUE, BETTY FAYE (COTA/L)
Entity Type:Individual
Prefix:MS
First Name:BETTY FAYE
Middle Name:
Last Name:BLUE
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 1:5 VASSAR DR
Mailing Address - Street 2:
Mailing Address - City:REHOBOTH BEACH
Mailing Address - State:DE
Mailing Address - Zip Code:19971-9420
Mailing Address - Country:US
Mailing Address - Phone:443-614-8872
Mailing Address - Fax:
Practice Address - Street 1:17028 CADBURY CIR
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-7022
Practice Address - Country:US
Practice Address - Phone:443-614-8872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-08
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant