Provider Demographics
NPI:1508157751
Name:WORKENTIN, DANALYN ELIZABETH MARIE (OTD)
Entity Type:Individual
Prefix:DR
First Name:DANALYN
Middle Name:ELIZABETH MARIE
Last Name:WORKENTIN
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:DR
Other - First Name:DANALYN
Other - Middle Name:ELIZABETH MARIE
Other - Last Name:DOLATA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTD
Mailing Address - Street 1:8225 MALLOW MIRROR LN
Mailing Address - Street 2:
Mailing Address - City:LAND O' LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34637
Mailing Address - Country:US
Mailing Address - Phone:208-571-1180
Mailing Address - Fax:
Practice Address - Street 1:8225 MALLOW MIRROR LN
Practice Address - Street 2:
Practice Address - City:LAND O' LAKES
Practice Address - State:FL
Practice Address - Zip Code:34637-3463
Practice Address - Country:US
Practice Address - Phone:208-571-1180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-22
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDOT845225X00000X
OR23382225X00000X
WAOT 60178977225X00000X
FLOT17655225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist