Individual
DEBRA A STATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR-L CLT MFRP
Contact information
Practice address
608 MIFFLIN ST, HUNTINGDON, PA 16652
(814) 386-9984
(814) 299-8467
Mailing address
15428 RAYSTOWN RD, JAMES CREEK, PA 16657-8705
(814) 386-9984
(814) 299-8467
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC008293
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12110724
CAQH
PA
Enumeration date
10/11/2006
Last updated
08/16/2022
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