Provider Demographics
NPI:1538183876
Name:BADGER, DEBORA MARIE (OCCUPATIONAL THERAPI)
Entity type:Individual
Prefix:MRS
First Name:DEBORA
Middle Name:MARIE
Last Name:BADGER
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPI
Other - Prefix:MRS
Other - First Name:DEBBIE
Other - Middle Name:MARIE
Other - Last Name:BADGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:53 GRAY BIRCH LN
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:ME
Mailing Address - Zip Code:04027-3324
Mailing Address - Country:US
Mailing Address - Phone:207-475-3255
Mailing Address - Fax:207-457-1525
Practice Address - Street 1:1068 MAIN ST
Practice Address - Street 2:DUNHAM STREET
Practice Address - City:SANFORD
Practice Address - State:ME
Practice Address - Zip Code:04073-3606
Practice Address - Country:US
Practice Address - Phone:207-475-3255
Practice Address - Fax:207-457-1525
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT1321171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor