Provider Demographics
NPI:1689792590
Name:DENNIS, DAWN (COTA)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:
Last Name:DENNIS
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7859 BERGAMO AVE
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34238-4758
Mailing Address - Country:US
Mailing Address - Phone:443-690-5942
Mailing Address - Fax:
Practice Address - Street 1:741 S BENEVA RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232-2411
Practice Address - Country:US
Practice Address - Phone:941-957-0310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00290224Z00000X
FLOTA 12757224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant