Provider Demographics
NPI:1760140669
Name:DUNNING, DOREENA MARIE (OTR/L, CAPS)
Entity Type:Individual
Prefix:MS
First Name:DOREENA
Middle Name:MARIE
Last Name:DUNNING
Suffix:
Gender:F
Credentials:OTR/L, CAPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1403 LEWIS AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-1742
Mailing Address - Country:US
Mailing Address - Phone:269-326-0042
Mailing Address - Fax:
Practice Address - Street 1:288 PEACE BLVD
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-9562
Practice Address - Country:US
Practice Address - Phone:269-556-9050
Practice Address - Fax:269-556-9095
Is Sole Proprietor?:No
Enumeration Date:2021-12-08
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201007348225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology