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Individual

DEB JEAN DEDECKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS OTR/L

Contact information

Practice address
9261 W VAN BUREN ST, TOLLESON, AZ 85353-2941
(623) 936-9740
(623) 907-5187
Mailing address
14300 N 83RD AVE, APARTMENT 2016, PEORIA, AZ 85381-4624
(623) 776-0159

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OT LICENSE #2619
AZ

Other

Enumeration date
11/01/2006
Last updated
07/08/2007
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