Provider Demographics
NPI:1821407008
Name:HARRISON, DANA (OTR/L)
Entity Type:Individual
Prefix:MISS
First Name:DANA
Middle Name:
Last Name:HARRISON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MRS
Other - First Name:DANA
Other - Middle Name:HARRISON
Other - Last Name:WELLS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1732 ROBINHOOD RD
Mailing Address - Street 2:
Mailing Address - City:CALLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:24530-3532
Mailing Address - Country:US
Mailing Address - Phone:540-875-7242
Mailing Address - Fax:
Practice Address - Street 1:1607 SPRUCE STREET EXT
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-5814
Practice Address - Country:US
Practice Address - Phone:276-632-7146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119005875225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist