Provider Demographics
NPI:1255967030
Name:DANIEL, RHONDA MICHELLE (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:MICHELLE
Last Name:DANIEL
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MRS
Other - First Name:RHONDA
Other - Middle Name:MICHELLE
Other - Last Name:DEVINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:137 MONTREAT CT
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-5473
Mailing Address - Country:US
Mailing Address - Phone:334-200-6564
Mailing Address - Fax:
Practice Address - Street 1:501 N WOODBURN DR
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303-1995
Practice Address - Country:US
Practice Address - Phone:334-200-6564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-12
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1709224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant