Provider Demographics
NPI:1629638911
Name:O'HARA, DEBRAH LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:DEBRAH
Middle Name:LEE
Last Name:O'HARA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18291 HIGHLAND RD STE 105
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-3934
Mailing Address - Country:US
Mailing Address - Phone:225-242-9882
Mailing Address - Fax:
Practice Address - Street 1:18291 HIGHLAND RD STE 105
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-3934
Practice Address - Country:US
Practice Address - Phone:225-242-9882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1867111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor