Provider Demographics
NPI:1023297025
Name:STUBBLEBINE, DANA MICHELE (OTR)
Entity type:Individual
Prefix:MRS
First Name:DANA
Middle Name:MICHELE
Last Name:STUBBLEBINE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MISS
Other - First Name:DANA
Other - Middle Name:MICHELE
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:860 SCENERY PL
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-5323
Mailing Address - Country:US
Mailing Address - Phone:717-554-1044
Mailing Address - Fax:
Practice Address - Street 1:5225 WILSON LN
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-6663
Practice Address - Country:US
Practice Address - Phone:717-591-8063
Practice Address - Fax:717-697-6576
Is Sole Proprietor?:No
Enumeration Date:2007-10-26
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC009098225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist