Provider Demographics
NPI:1639468481
Name:SCHELLER, DEBORA ANN (LMT)
Entity type:Individual
Prefix:
First Name:DEBORA
Middle Name:ANN
Last Name:SCHELLER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1329 W SACK DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-5450
Mailing Address - Country:US
Mailing Address - Phone:602-380-3193
Mailing Address - Fax:
Practice Address - Street 1:13231 N 35TH AVE
Practice Address - Street 2:#A-6
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-1233
Practice Address - Country:US
Practice Address - Phone:602-380-3193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-01
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-12575225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist