Debra Ann Goodreau, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

359 Issued in MA

Practice address

464 Main St
Agawam, MA 01001-1826

Phone

(413) 786-8000

Fax

(413) 821-0733

NPI assigned

Mar 20, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Debra Ann Dechellis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942325659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "599 CENTER ST",
            "city": "LUDLOW",
            "state": "MA",
            "postal_code": "010561460",
            "telephone_number": "413-583-6237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "464 MAIN ST",
            "city": "AGAWAM",
            "state": "MA",
            "postal_code": "010011826",
            "telephone_number": "413-786-8000",
            "fax_number": "413-821-0733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODREAU",
        "first_name": "DEBRA",
        "middle_name": "ANN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MA",
            "license": "359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBRA",
            "last_name": "DECHELLIS",
            "middle_name": "ANN",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stephanie Girard
• Pamela Glemboski, RPH
• Thomas Gobeille, RPH
• Kathleen Goddard, PT
• Sybel Gonzalez
• Gary M. Gorman, D.C.
• Daniel Griffin IV, PT, DPT
• Megan Grimard, OTR/L
• Monique Susanne Groux
• Josephine Hapgood, PTA

• Physical Therapy Assistant in Agawam, MA
• Providers in Agawam, MA by specialty
• Physical Therapy Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.