Provider Demographics
NPI:1619130960
Name:WURM, DANA MICHELE (MS, OTR, CLT)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:MICHELE
Last Name:WURM
Suffix:
Gender:F
Credentials:MS, OTR, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 GLEN STEWART DR
Mailing Address - Street 2:
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-1950
Mailing Address - Country:US
Mailing Address - Phone:518-669-2299
Mailing Address - Fax:
Practice Address - Street 1:23659 COLUMBUS RD
Practice Address - Street 2:SUITE 3
Practice Address - City:COLUMBUS
Practice Address - State:NJ
Practice Address - Zip Code:08022-1980
Practice Address - Country:US
Practice Address - Phone:609-324-1200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-08
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00472200225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist