Provider Demographics
NPI:1518081355
Name:SOUDER-PELAEZ, DEBORAH LEIGH (OTR L)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:LEIGH
Last Name:SOUDER-PELAEZ
Suffix:
Gender:F
Credentials:OTR L
Other - Prefix:MISS
Other - First Name:DEBORAH
Other - Middle Name:LEIGH
Other - Last Name:SOUDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR L
Mailing Address - Street 1:126 SCHOOLHOUSE LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-1035
Mailing Address - Country:US
Mailing Address - Phone:854-273-9897
Mailing Address - Fax:856-786-8130
Practice Address - Street 1:1700 WYNWOOD DR
Practice Address - Street 2:
Practice Address - City:CINNAMINSON
Practice Address - State:NJ
Practice Address - Zip Code:08077-2440
Practice Address - Country:US
Practice Address - Phone:856-289-9000
Practice Address - Fax:856-786-8130
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR000340225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist