Healthcare Provider Details

I. General information

NPI: 1578713368
Provider Name (Legal Business Name): DEBORAH PROPST BECKER OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2008
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

398 BLUE JAY DR
LIBERTY MO
64068-1977
US

IV. Provider business mailing address

1400 N ELSEA SMITH RD
INDEPENDENCE MO
64056-4114
US

V. Phone/Fax

Practice location:
  • Phone: 816-407-2315
  • Fax:
Mailing address:
  • Phone: 816-650-4020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number001036
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: