Individual
DEBBIE RACHELLE PRINCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1685 SHAFFER RD, ATWATER, CA 95301-4456
(209) 357-3420
(209) 356-2486
Mailing address
1685 SHAFFER RD, ATWATER, CA 95301-4456
(209) 357-3420
(209) 356-2486
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT3456
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
555244
MEDICARE PROVIDER NUMBER
CA
Enumeration date
09/09/2008
Last updated
09/09/2008
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