Provider Demographics
NPI:1144560178
Name:LATOUR, DEBRA (OTR/L)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:LATOUR
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10941-4064
Mailing Address - Country:US
Mailing Address - Phone:845-956-0001
Mailing Address - Fax:
Practice Address - Street 1:4 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10941-4064
Practice Address - Country:US
Practice Address - Phone:845-956-0001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-28
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017688-1225XP0019X
MA1735225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation