Provider Demographics
NPI:1316590466
Name:SMITH, DANA M (OTR)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:M
Last Name:SMITH
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4005 ANDREWS RD
Mailing Address - Street 2:
Mailing Address - City:RANSOMVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14131-9540
Mailing Address - Country:US
Mailing Address - Phone:716-534-4927
Mailing Address - Fax:
Practice Address - Street 1:6385 LOCUST STREET EXT
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094-6511
Practice Address - Country:US
Practice Address - Phone:716-478-4770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-18
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist