Provider Demographics
NPI:1043842966
Name:BRASS, DEBORAH (ATR-BC, LCAT)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:BRASS
Suffix:
Gender:F
Credentials:ATR-BC, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 EDWARDS PL APT B2
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10703-2442
Mailing Address - Country:US
Mailing Address - Phone:617-256-7109
Mailing Address - Fax:
Practice Address - Street 1:465 BROADWAY
Practice Address - Street 2:
Practice Address - City:HASTINGS ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10706-2332
Practice Address - Country:US
Practice Address - Phone:617-256-7109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-08
Last Update Date:2020-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001913-1221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist