Provider Demographics
NPI:1811385909
Name:GROSSMAN, DEBBIE SUE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:DEBBIE
Middle Name:SUE
Last Name:GROSSMAN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:971 S IDAHO ST UNIT 16
Mailing Address - Street 2:
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-6639
Mailing Address - Country:US
Mailing Address - Phone:562-500-1983
Mailing Address - Fax:562-697-4552
Practice Address - Street 1:971 S IDAHO ST UNIT 16
Practice Address - Street 2:
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-6639
Practice Address - Country:US
Practice Address - Phone:562-500-1983
Practice Address - Fax:562-697-4552
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-25
Last Update Date:2014-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1911225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist