Individual
DEANNA ELAINE STATEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6322 SANTO PL, CAPITOL HEIGHTS, MD 20743-3258
(252) 402-7276
Mailing address
6322 SANTO PL, CAPITOL HEIGHTS, MD 20743-3258
(252) 402-7276
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT010000984
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0
N/A
MD
Enumeration date
10/04/2022
Last updated
10/04/2022
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