Individual
DEANNA M DETHOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
7333 INTERNATIONAL PL, LAKEWOOD RANCH, FL 34240-8418
(914) 712-5198
Mailing address
6019 BROAD RIVER RUN, ELLENTON, FL 34222-7270
(914) 712-5198
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
018042-1
NY
225X00000X
Occupational Therapist
5276
SC
225X00000X
Occupational Therapist
Primary
OT20466
FL
225X00000X
Occupational Therapist
P86854
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114633100
—
FL
Enumeration date
02/04/2013
Last updated
09/21/2022
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