Individual
MS. DEBORAH LAVENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
R0391
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
194278
BLUE CROSS/BLUE SHIELD
MO
01
—
2243013
FIRST HEALTH
MO
01
—
690261
HEALTHLINK
MO
01
—
7635608
AETNA
MO
01
—
9195935
PHCS
MO
Enumeration date
07/21/2005
Last updated
02/15/2008
Update your record
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