Individual
DEBORAH BACCHUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
4355 PHEASANT RIDGE RD, ROANOKE, VA 24014-5272
(540) 725-8210
Mailing address
630 HEMLOCK RD NW, ROANOKE, VA 24017-4774
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131000060
VA
Other
Enumeration date
12/15/2023
Last updated
12/15/2023
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