Provider Demographics
NPI:1669830105
Name:OCCUPATIONAL THERAPY OF DELAWARE
Entity Type:Organization
Organization Name:OCCUPATIONAL THERAPY OF DELAWARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:J
Authorized Official - Last Name:DISSINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-491-4813
Mailing Address - Street 1:550 S DUPONT BLVD
Mailing Address - Street 2:SUITE E
Mailing Address - City:MILFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19963-1704
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:550 S DUPONT BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-1704
Practice Address - Country:US
Practice Address - Phone:302-491-4813
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-28
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty