Provider Demographics
NPI:1184940157
Name:BARHAM, DEBORAH C (OTR/L; L AC)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:C
Last Name:BARHAM
Suffix:
Gender:F
Credentials:OTR/L; L AC
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:CLONTZ
Other - Last Name:BARHAM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR/L; L AC
Mailing Address - Street 1:PO BOX 11012
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28603-4512
Mailing Address - Country:US
Mailing Address - Phone:828-773-9473
Mailing Address - Fax:
Practice Address - Street 1:432 4TH AVE SW
Practice Address - Street 2:HICKORY PUBLIC SCHOOLS ADMIN OFFICE
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-2805
Practice Address - Country:US
Practice Address - Phone:828-322-2855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-15
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC331171100000X
NC236225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No171100000XOther Service ProvidersAcupuncturist