Provider Demographics
NPI:1578807194
Name:PRICE, DEBORAH SUE (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:SUE
Last Name:PRICE
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 1:1690 ANSONBOROUGH DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-5644
Mailing Address - Country:US
Mailing Address - Phone:636-537-9993
Mailing Address - Fax:505-468-8185
Practice Address - Street 1:1690 ANSONBOROUGH DR
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-5644
Practice Address - Country:US
Practice Address - Phone:636-537-9993
Practice Address - Fax:505-468-8185
Is Sole Proprietor?:No
Enumeration Date:2012-11-20
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000819225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist