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Individual

DEBRA ANN BACCHUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
13010 144TH ST, JAMAICA, NY 11436-2214
(718) 781-5417
(718) 322-7480
Mailing address
13010 144TH ST, JAMAICA, NY 11436-2214
(718) 781-5417

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
225500000X
Respiratory/Developmental/Rehabilitative Specialist/Technologist

Other

Enumeration date
10/30/2015
Last updated
10/30/2015
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