=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386864700
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DEBORA DIERWECHTER HHA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/26/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2250 HICKORY ROAD SUITE 240
-----------------------------------------------------
City | PLYMOUTH MEETING
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19462
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-834-1122
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11 OAKEDELL ESTATES
-----------------------------------------------------
City | ORWIGSBURG
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17961
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 570-366-1913
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 374U00000X
-----------------------------------------------------
Taxonomy Name | Home Health Aide
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------