Provider Demographics
NPI:1659689081
Name:BURTON, DE'ANN (OTR/L)
Entity type:Individual
Prefix:
First Name:DE'ANN
Middle Name:
Last Name:BURTON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 ROTTERDAM AVE
Mailing Address - Street 2:
Mailing Address - City:ELLENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34222-3450
Mailing Address - Country:US
Mailing Address - Phone:941-757-6173
Mailing Address - Fax:
Practice Address - Street 1:216 ROTTERDAM AVE
Practice Address - Street 2:
Practice Address - City:ELLENTON
Practice Address - State:FL
Practice Address - Zip Code:34222-3450
Practice Address - Country:US
Practice Address - Phone:941-757-6173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-20
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT12903225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist