Provider Demographics
NPI:1467774968
Name:DEBAUN, NANCY (OTR/L)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:DEBAUN
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 1:10 CANDLESTICK LN
Mailing Address - Street 2:
Mailing Address - City:SANDOWN
Mailing Address - State:NH
Mailing Address - Zip Code:03873-2364
Mailing Address - Country:US
Mailing Address - Phone:603-505-4154
Mailing Address - Fax:
Practice Address - Street 1:126 MONUMENT ST
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01832-2527
Practice Address - Country:US
Practice Address - Phone:978-373-1747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-24
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0375225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation