MEDICARE: DEBORAH ALLEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XP0019X	Physical Rehabilitation Occupational Therapist

General Provider Information

NPI Number	:	1518100023
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEBORAH ALLEN

Provider Business Mailing Address
First Line	:	4133 MARLWOOD DR
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48323-2749
Country	:	US
Telephone Number	:	248-682-6923
Fax Number	:

Provider Business Practice Location Address
First Line	:	4133 MARLWOOD DR
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48323-2749
Country	:	US
Telephone Number	:	248-682-6923
Fax Number	:

Authorized Official
Title or Position	:	OCCUPATIONAL THERAPIST
Name	:	MRS. DEBORAH ALLEN
Credential	:	MS, OTR
Telephone Number	:	248-682-6923

Provider Enumeration Date	:	04/14/2009
Last Update Date	:	04/15/2009

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