Provider Demographics
NPI: | 1851402044 |
---|---|
Name: | SMEED, DEBORAH ANN (OTR/L) |
Entity Type: | Individual |
Prefix: | MS |
First Name: | DEBORAH |
Middle Name: | ANN |
Last Name: | SMEED |
Suffix: | |
Gender: | F |
Credentials: | 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: | 21445 N 78TH ST |
Mailing Address - Street 2: | |
Mailing Address - City: | SCOTTSDALE |
Mailing Address - State: | AZ |
Mailing Address - Zip Code: | 85255-7718 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 480-515-2157 |
Mailing Address - Fax: | 480-585-4425 |
Practice Address - Street 1: | 7501 E THOMPSON PEAK PKWY |
Practice Address - Street 2: | |
Practice Address - City: | SCOTTSDALE |
Practice Address - State: | AZ |
Practice Address - Zip Code: | 85255-4525 |
Practice Address - Country: | US |
Practice Address - Phone: | 480-361-3231 |
Practice Address - Fax: | 480-219-9187 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-08-31 |
Last Update Date: | 2007-07-08 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
AZ | 0717 | 225X00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
AZ | Z104610 | Medicare ID - Type Unspecified | GROUP PROVIDER NUMBER |
AZ | Z104618 | Medicare ID - Type Unspecified | OCCUPATIONAL THERAPIST |