Provider Demographics
NPI:1720397177
Name:GARRELTS, DEBORAH MARIE (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:MARIE
Last Name:GARRELTS
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 QUAKER ST
Mailing Address - Street 2:
Mailing Address - City:GRANVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12832-1513
Mailing Address - Country:US
Mailing Address - Phone:518-642-1051
Mailing Address - Fax:
Practice Address - Street 1:58 QUAKER ST
Practice Address - Street 2:
Practice Address - City:GRANVILLE
Practice Address - State:NY
Practice Address - Zip Code:12832-1513
Practice Address - Country:US
Practice Address - Phone:518-642-1051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009063-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics