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Individual

DEANDRA DEMES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
7620 SOUTHERN BLVD, SUITE 3, BOARDMAN, OH 44512-5667
(330) 965-9330
(330) 965-9308
Mailing address
7620 SOUTHERN BLVD, SUITE 3, BOARDMAN, OH 44512-5667
(330) 965-9330
(330) 965-9308

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT04982
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000208504
ANTHEM
OH
01
34181049501
BWC
OH
Enumeration date
07/03/2006
Last updated
03/10/2009
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