Provider Demographics
NPI:1275706582
Name:DAVA, MARIA ELVIRA (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:ELVIRA
Last Name:DAVA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3824 KINGSWAY DR
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-8982
Mailing Address - Country:US
Mailing Address - Phone:630-362-3854
Mailing Address - Fax:219-397-1249
Practice Address - Street 1:3824 KINGSWAY DR
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-8982
Practice Address - Country:US
Practice Address - Phone:630-362-3854
Practice Address - Fax:219-397-1249
Is Sole Proprietor?:No
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31004453A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist