Individual ProviderMary Ellen DeffenbaughOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address2203 Babcock Rd, San Antonio, TX 78229-4412(210) 614-3911PECOS EnrollmentBased on the most recent information from CMS, provider Mary Ellen Deffenbaugh does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1235680166Provider TypeIndividualFull NameDeffenbaugh, Mary EllenCredentialOTRGenderFemaleSole ProprietorYesEnumeration Date10/15/2016Last Updated10/15/2016Contact InformationPractice LocationPractice Address2203 Babcock Rd, San Antonio, TX 78229-4412Phone(210) 614-3911FaxUnlisted FaxMailing LocationMailing Address2203 Babcock Rd, San Antonio, TX 78229-4412Phone(210) 614-3911FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225X00000XPrimaryDescriptionOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense102567Texas