Basic Information
| Provider Information | |||||||||
| NPI: | 1386063204 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | VAN ALLEN | ||||||||
| FirstName: | DEANA | ||||||||
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| Credential: | COTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2316 BERT YANCEY DR | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799362702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2546818662 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6601 MONTANA AVE | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799252155 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9158387604 | ||||||||
| FaxNumber: | 9157724633 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/08/2014 | ||||||||
| LastUpdateDate: | 04/08/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | 209583 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
No ID Information.