Provider Demographics
NPI:1437304896
Name:DESSANTI, DIANNE MARIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:DIANNE
Middle Name:MARIE
Last Name:DESSANTI
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 1:6 SHALE RD
Mailing Address - Street 2:
Mailing Address - City:BEACON
Mailing Address - State:NY
Mailing Address - Zip Code:12508-1414
Mailing Address - Country:US
Mailing Address - Phone:845-831-2013
Mailing Address - Fax:
Practice Address - Street 1:6 SHALE RD
Practice Address - Street 2:
Practice Address - City:BEACON
Practice Address - State:NY
Practice Address - Zip Code:12508-1414
Practice Address - Country:US
Practice Address - Phone:845-831-2013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009962-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist