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General NPI Number Information
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NPI Number | 1063551679
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Entity Type | Individual
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Provider Name | DEBRA PASMORE BRADSHER OTR
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Gender | Female
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 08/31/2021
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Provider Practice Location Address
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Address Line | 90 CLARK BLVD
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City | TUPELO
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State | MS
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Zip | 38804-2801
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Country | US
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Telephone | 662-840-0535
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Fax |
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Provider Business Mailing Address
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Address Line | 466 COUNTY ROAD 1740
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City | TUPELO
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State | MS
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Zip | 38804-7129
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Country | US
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Telephone | 870-243-2695
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OTR1841
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License Number State | AR
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