Provider Demographics
NPI:1023207354
Name:JOHNSON, DANA (PHD, MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:PHD, MS, OTR/L
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:
Other - Last Name:HOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OTR/L
Mailing Address - Street 1:1816 HEALTH CARE DR.
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-4982
Mailing Address - Country:US
Mailing Address - Phone:727-326-7791
Mailing Address - Fax:727-645-5620
Practice Address - Street 1:1816 HEALTH CARE DR
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-5362
Practice Address - Country:US
Practice Address - Phone:727-326-7791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Q00000X
FLOT 13065225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist