Provider Demographics
NPI:1023597184
Name:DUNCAN BERNARD, DEBRA CAROL (COTA)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:CAROL
Last Name:DUNCAN BERNARD
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 1:264 SE SAINT LUCIE BLVD APT 203
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34996-1396
Mailing Address - Country:US
Mailing Address - Phone:772-212-5590
Mailing Address - Fax:
Practice Address - Street 1:264 SE SAINT LUCIE BLVD APT 203
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34996-1396
Practice Address - Country:US
Practice Address - Phone:772-212-5590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant