Healthcare Provider Details

I. General information

NPI: 1841425519
Provider Name (Legal Business Name): ROBIN MELINDA DEACY MS, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2009
Last Update Date: 05/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 UNIVERSITY BLVD SUITE 405
BIRMINGHAM AL
35233-1816
US

IV. Provider business mailing address

1720 UNIVERSITY BLVD SUITE 405
BIRMINGHAM AL
35233-1816
US

V. Phone/Fax

Practice location:
  • Phone: 205-488-0743
  • Fax: 205-488-0746
Mailing address:
  • Phone: 205-488-0743
  • Fax: 205-488-0746

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2615
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: