Basic Information
| Provider Information | |||||||||
| NPI: | 1487894341 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HANEY | ||||||||
| FirstName: | DEBRA | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | OT | ||||||||
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| OtherLastName: | OBLANDER | ||||||||
| OtherFirstName: | DEBRA | ||||||||
| OtherMiddleName: | D | ||||||||
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| OtherCredential: | OT | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 136 CORPORATE PARK DR | ||||||||
| Address2: | SUITE A | ||||||||
| City: | MOORESVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 281176959 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7043602796 | ||||||||
| FaxNumber: | 7043607898 | ||||||||
| Practice Location | |||||||||
| Address1: | 870 SUMMIT CROSSING PL | ||||||||
| Address2: | |||||||||
| City: | GASTONIA | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280542192 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7043232000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/04/2009 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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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 | 225X00000X | 2803 | NC | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.