Provider Demographics
NPI:1740484708
Name:FIELDS, LUCY DEBLANC (OTR)
Entity type:Individual
Prefix:
First Name:LUCY
Middle Name:DEBLANC
Last Name:FIELDS
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 1:1005 REBECCA LN
Mailing Address - Street 2:
Mailing Address - City:BRIDGE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77611-3128
Mailing Address - Country:US
Mailing Address - Phone:409-738-2773
Mailing Address - Fax:
Practice Address - Street 1:4201 FM 105
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:TX
Practice Address - Zip Code:77630-1272
Practice Address - Country:US
Practice Address - Phone:409-670-1457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100494225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist