Provider Demographics
NPI:1528589371
Name:TYLER, DEBORAH LANE (OTR/L)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LANE
Last Name:TYLER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5379 CONIFER DR
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-8728
Mailing Address - Country:US
Mailing Address - Phone:513-476-6969
Mailing Address - Fax:
Practice Address - Street 1:5467 CEDAR VILLAGE DR
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-8693
Practice Address - Country:US
Practice Address - Phone:513-336-3122
Practice Address - Fax:513-336-3191
Is Sole Proprietor?:No
Enumeration Date:2017-07-02
Last Update Date:2017-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT006169225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist