Provider Demographics
NPI:1184282204
Name:CAMPBELL, DEBORA SEMELISS (OTR)
Entity type:Individual
Prefix:
First Name:DEBORA
Middle Name:SEMELISS
Last Name:CAMPBELL
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 1:1518 YONKEE DR
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-4679
Mailing Address - Country:US
Mailing Address - Phone:970-297-8850
Mailing Address - Fax:
Practice Address - Street 1:1518 YONKEE DR
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-4679
Practice Address - Country:US
Practice Address - Phone:970-297-8850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-04
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2882225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation