Provider Demographics
NPI:1881216836
Name:BOYNE, DEBORAH FRANCES (COTA)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:FRANCES
Last Name:BOYNE
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1149 HIGHVIEW DR
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-3363
Mailing Address - Country:US
Mailing Address - Phone:810-441-4101
Mailing Address - Fax:
Practice Address - Street 1:3200 STATE ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-3475
Practice Address - Country:US
Practice Address - Phone:989-341-8060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-13
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5202008623224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant