Healthcare Provider Details

I. General information

NPI: 1396155347
Provider Name (Legal Business Name): DEANNA FINNEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2014
Last Update Date: 04/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4450 W EAU GALLIE BLVD STE 180
MELBOURNE FL
32934-7277
US

IV. Provider business mailing address

13 HARDEE CIR N
ROCKLEDGE FL
32955-2406
US

V. Phone/Fax

Practice location:
  • Phone: 321-255-6627
  • Fax:
Mailing address:
  • Phone: 321-504-3753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT9405
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: