Provider Demographics
NPI:1952018491
Name:TURNER, DEBRA LYNN (COTA)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:LYNN
Last Name:TURNER
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 1:9538 S 300 W
Mailing Address - Street 2:
Mailing Address - City:WABASH
Mailing Address - State:IN
Mailing Address - Zip Code:46992-9152
Mailing Address - Country:US
Mailing Address - Phone:260-571-4543
Mailing Address - Fax:
Practice Address - Street 1:317 BLAIR PIKE
Practice Address - Street 2:
Practice Address - City:PERU
Practice Address - State:IN
Practice Address - Zip Code:46970-1507
Practice Address - Country:US
Practice Address - Phone:765-473-4426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN32002167A224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant