Provider Demographics
NPI:1760502256
Name:BONNER, DAPHNE ZIEGLER (OT)
Entity Type:Individual
Prefix:
First Name:DAPHNE
Middle Name:ZIEGLER
Last Name:BONNER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:DAPHNE
Other - Middle Name:MICHELE
Other - Last Name:ZIEGLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1932 NILES CORTLAND RD NE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-1055
Mailing Address - Country:US
Mailing Address - Phone:330-856-1520
Mailing Address - Fax:330-856-7342
Practice Address - Street 1:1932 NILES CORTLAND RD NE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-1055
Practice Address - Country:US
Practice Address - Phone:330-856-1520
Practice Address - Fax:330-856-7342
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT002319225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2577162Medicaid
OH366731Medicare ID - Type Unspecified