Organization
DEBRA A STATES, LLC
Active
Organization
DEBRA A STATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA A STATES OTR/L CLT MFRP (PRACTITIONER/OCCUPATIONAL THERAPIST)
(814) 386-9984
Entity
Organization
Contact information
Practice address
608 MIFFLIN ST, HUNTINGDON, PA 16657
(814) 386-9984
(814) 299-7320
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12110724
CAQH
PA
Enumeration date
05/09/2016
Last updated
08/18/2022
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