Individual
PATSY DEVEREAUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15362 KATHY CIR, COUNCIL BLUFFS, IA 51503-5806
(402) 689-1354
Mailing address
15362 KATHY CIR, COUNCIL BLUFFS, IA 51503-5806
Taxonomy
Speciality
Code
Description
License number
State
225500000X
Respiratory/Developmental/Rehabilitative Specialist/Technologist
683
NE
225500000X
Respiratory/Developmental/Rehabilitative Specialist/Technologist
Primary
793
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
683
STATE LICENSE NUMBER
NE
01
—
793
STATE LICENSE NUMBER
IA
Enumeration date
06/07/2007
Last updated
07/24/2015
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