Provider Demographics
NPI:1467873943
Name:LAMOTHE, DEBORAH (PT)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:
Last Name:LAMOTHE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:LOU
Other - Last Name:HIGGINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHYSICAL THERAPIST
Mailing Address - Street 1:576 QUAIL VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:WV
Mailing Address - Zip Code:24740-4150
Mailing Address - Country:US
Mailing Address - Phone:304-425-5155
Mailing Address - Fax:
Practice Address - Street 1:576 QUAIL VALLEY DR
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24740-4150
Practice Address - Country:US
Practice Address - Phone:304-425-5155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-30
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV962225100000X
ME00371225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist