Provider Demographics
NPI:1710145867
Name:LEVENSON, DEBORAH
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:LEVENSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:
Other - Last Name:MILLIGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:340 WOOD RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-2401
Mailing Address - Country:US
Mailing Address - Phone:781-535-6053
Mailing Address - Fax:
Practice Address - Street 1:340 WOOD RD
Practice Address - Street 2:SUITE 102
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-2401
Practice Address - Country:US
Practice Address - Phone:781-535-6053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11117225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist