Provider Demographics
NPI:1518048768
Name:DOOLEY, DEBORAH M (OTR, CLT)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:M
Last Name:DOOLEY
Suffix:
Gender:F
Credentials:OTR, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2334 N EL PASO ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-7019
Mailing Address - Country:US
Mailing Address - Phone:719-237-1477
Mailing Address - Fax:717-473-3779
Practice Address - Street 1:941A FILLMORE ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907
Practice Address - Country:US
Practice Address - Phone:719-237-1477
Practice Address - Fax:719-473-3779
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
970907225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO36909823Medicaid
CO485928Medicare ID - Type UnspecifiedOCCUPATIONAL THERAPIST