Provider Demographics
NPI:1881139590
Name:SCHUETZE, DEBORAH (COTA)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:SCHUETZE
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5265 FORBES TER
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33981-2248
Mailing Address - Country:US
Mailing Address - Phone:941-380-1950
Mailing Address - Fax:
Practice Address - Street 1:5265 FORBES TER
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33981-2248
Practice Address - Country:US
Practice Address - Phone:941-380-1950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-04
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA 15117224Z00000X
MI5202008084224Z00000X
MI7501008923225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist