Provider Demographics
NPI:1275762437
Name:TOBEY, DANA (COTA/L)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:TOBEY
Suffix:
Gender:M
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 HUNTER RD
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-0437
Mailing Address - Country:US
Mailing Address - Phone:207-623-5228
Mailing Address - Fax:
Practice Address - Street 1:226 WATER ST
Practice Address - Street 2:
Practice Address - City:GARDINER
Practice Address - State:ME
Practice Address - Zip Code:04345-2110
Practice Address - Country:US
Practice Address - Phone:207-582-5100
Practice Address - Fax:207-582-5100
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOA1251224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME266080099Medicaid