Provider Demographics
NPI:1568429793
Name:GROSS, DANA JO (OTR/L, CHT)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:JO
Last Name:GROSS
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 W CHESTER PIKE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-4500
Mailing Address - Country:US
Mailing Address - Phone:610-446-8410
Mailing Address - Fax:
Practice Address - Street 1:300 EVERGREEN DR
Practice Address - Street 2:SUITE 220
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-1059
Practice Address - Country:US
Practice Address - Phone:484-356-9401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC000200L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist