Provider Demographics
NPI:1467900811
Name:MISSMER, DANETTE LYNN
Entity Type:Individual
Prefix:MRS
First Name:DANETTE
Middle Name:LYNN
Last Name:MISSMER
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:DANETTE
Other - Middle Name:LYNN
Other - Last Name:SNYDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L, CHT
Mailing Address - Street 1:2597 SCHOENERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-7325
Mailing Address - Country:US
Mailing Address - Phone:484-884-2076
Mailing Address - Fax:
Practice Address - Street 1:2597 SCHOENERSVILLE RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-7325
Practice Address - Country:US
Practice Address - Phone:484-884-2076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-14
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC003998L225X00000X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist