Provider Demographics
NPI:1609026889
Name:CABEZAS, DEBORAH (PTA)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:CABEZAS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 EMERY ST
Mailing Address - Street 2:
Mailing Address - City:HOLBROOK
Mailing Address - State:MA
Mailing Address - Zip Code:02343-2020
Mailing Address - Country:US
Mailing Address - Phone:781-767-5526
Mailing Address - Fax:
Practice Address - Street 1:30 EMERY ST
Practice Address - Street 2:
Practice Address - City:HOLBROOK
Practice Address - State:MA
Practice Address - Zip Code:02343-2020
Practice Address - Country:US
Practice Address - Phone:781-767-5526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA203225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA161216796OtherSUPPLEMENTAL HEALTH CARE