Provider Demographics
NPI:1245874171
Name:YODER, DEBORAH (OTR)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:YODER
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 1:786 INDIAN CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND FURNACE
Mailing Address - State:TN
Mailing Address - Zip Code:37051-9060
Mailing Address - Country:US
Mailing Address - Phone:931-216-5348
Mailing Address - Fax:
Practice Address - Street 1:2035 VANTAGE POINTE
Practice Address - Street 2:
Practice Address - City:ASHLAND CITY
Practice Address - State:TN
Practice Address - Zip Code:37015-4093
Practice Address - Country:US
Practice Address - Phone:615-792-2787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-04
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1755225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist