Provider Demographics
NPI:1841755816
Name:BALL, DAYNA (OTA)
Entity Type:Individual
Prefix:
First Name:DAYNA
Middle Name:
Last Name:BALL
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 90758
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77290-0758
Mailing Address - Country:US
Mailing Address - Phone:713-732-0180
Mailing Address - Fax:
Practice Address - Street 1:1422 SWEET GRASS TRL
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-1845
Practice Address - Country:US
Practice Address - Phone:713-732-0180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-04
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX213518224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant