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NPI Code Detail

MEDICARE: MRS. DARCELLE CROOKE DECKER OTR

MEDICARE: MRS. DARCELLE CROOKE DECKER OTR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225XH1200XHand Occupational TherapistOC-002426-LPA

General Provider Information

NPI Number : 1992232532
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DARCELLE CROOKE DECKER OTR
Provider Business Mailing Address
First Line : 112 N ARDMOOR AVE
Second Line :
City : DANVILLE
State : PA
Zip : 17821-1212
Country : US
Telephone Number : 570-275-7545
Fax Number :
Provider Business Practice Location Address
First Line : 480 CENTRAL RD
Second Line :
City : BLOOMSBURG
State : PA
Zip : 17815-3121
Country : US
Telephone Number : 570-387-6150
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2017
Last Update Date : 03/17/2018

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