Deborah Dubose

Individual provider Active NPI Occupational Therapy Assistant · Jacksonville, TX

NPI 1992284251 · NPPES record last updated Aug 8, 2018

Key facts

NPI
1992284251
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
210330 (TX)
Practice address
421 S Bonner St
Jacksonville, TX 75766-2330
Phone
(903) 586-9871
NPI assigned
Aug 8, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
210330TXMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 210330 TX Yes

Addresses

Primary practice location

421 S Bonner St
Jacksonville, TX 75766-2330

Mailing address

1026 FM 3343
Joaquin, TX 75954-3370
Phone (936) 269-9431

Other providers in Jacksonville, TX

All providers in Jacksonville, TX · Occupational Therapy Assistant in Texas

Sources for this page

Verify at the official NPI Registry.