Individual
DEBORAH STAUFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
225X00000X
Occupational Therapist
Primary
10392456-4201
UT
247200000X
Other Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396085718
—
UT
Enumeration date
05/31/2016
Last updated
11/19/2019
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