Individual
SIDNEY DEATHERAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
77564 COUNTRY CLUB DR STE 401B, PALM DESERT, CA 92211-6246
(760) 772-2838
(760) 772-2883
Mailing address
77564 COUNTRY CLUB DR STE 401B, PALM DESERT, CA 92211-6246
(760) 772-2838
(760) 772-2883
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
6302
CA
Other
Enumeration date
01/03/2023
Last updated
01/03/2023
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