Provider Demographics
NPI:1366872228
Name:DEBEVOISE, TAMMY MARIE (DPT)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:MARIE
Last Name:DEBEVOISE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10010 FALLS OF NEUSE RD STE 9
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614-8495
Mailing Address - Country:US
Mailing Address - Phone:919-350-1508
Mailing Address - Fax:919-350-1475
Practice Address - Street 1:10010 FALLS OF NEUSE RD STE 9
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614-8495
Practice Address - Country:US
Practice Address - Phone:919-350-1508
Practice Address - Fax:919-350-1475
Is Sole Proprietor?:No
Enumeration Date:2013-11-13
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1237011225100000X
NCP20946225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist