Provider Demographics
NPI:1952883670
Name:OLIVER, DEBORAH C (OTR, OTD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:C
Last Name:OLIVER
Suffix:
Gender:F
Credentials:OTR, OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 E LEAGUE CITY PKWY APT 212
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-2890
Mailing Address - Country:US
Mailing Address - Phone:615-482-1524
Mailing Address - Fax:
Practice Address - Street 1:1750 E LEAGUE CITY PKWY APT 212
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-2890
Practice Address - Country:US
Practice Address - Phone:615-482-1524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111717225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist