Provider Demographics
NPI:1225736010
Name:GOSSAGE, DAYNA MICHELE (COTA)
Entity Type:Individual
Prefix:
First Name:DAYNA
Middle Name:MICHELE
Last Name:GOSSAGE
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:458 ALLENVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-6167
Mailing Address - Country:US
Mailing Address - Phone:717-847-0180
Mailing Address - Fax:
Practice Address - Street 1:1700 MARKET ST
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-4817
Practice Address - Country:US
Practice Address - Phone:717-737-8551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP010347224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant