Provider Demographics
NPI:1518093970
Name:YOUNG, DEBRA (MED,OTR/L,SCEM,ATP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MED,OTR/L,SCEM,ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 SYRACUSE DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-8101
Mailing Address - Country:US
Mailing Address - Phone:302-981-3362
Mailing Address - Fax:
Practice Address - Street 1:107 SYRACUSE DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-8101
Practice Address - Country:US
Practice Address - Phone:302-981-3362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEU1-0000827225XE0001X
PAOC004472L225XE0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XE0001XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistEnvironmental Modification