Provider Demographics
NPI:1952554131
Name:ALLEN, DEBRA COLLETTE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:COLLETTE
Last Name:ALLEN
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 1:15 SLY POND RD
Mailing Address - Street 2:
Mailing Address - City:FORT ANN
Mailing Address - State:NY
Mailing Address - Zip Code:12827-3300
Mailing Address - Country:US
Mailing Address - Phone:518-793-6222
Mailing Address - Fax:
Practice Address - Street 1:15 SLY POND RD
Practice Address - Street 2:
Practice Address - City:FORT ANN
Practice Address - State:NY
Practice Address - Zip Code:12827-3300
Practice Address - Country:US
Practice Address - Phone:518-793-6222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-31
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007296-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist