Provider Demographics
NPI:1508277203
Name:WHITE-LYONS, DEBORAH LOUISE
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:LOUISE
Last Name:WHITE-LYONS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:DEBORAH
Other - Middle Name:LOUISE
Other - Last Name:WHITE-LYONS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN,ATC,RPT
Mailing Address - Street 1:5 HEARTHSIDE CT
Mailing Address - Street 2:
Mailing Address - City:SCITUATE
Mailing Address - State:MA
Mailing Address - Zip Code:02066-3848
Mailing Address - Country:US
Mailing Address - Phone:781-771-3406
Mailing Address - Fax:
Practice Address - Street 1:5 HEARTHSIDE CT
Practice Address - Street 2:
Practice Address - City:SCITUATE
Practice Address - State:MA
Practice Address - Zip Code:02066-3848
Practice Address - Country:US
Practice Address - Phone:781-771-3406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-15
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA242255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer