Provider Demographics
NPI:1669796637
Name:DAVA, MARIA CECILIA (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:CECILIA
Last Name:DAVA
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:CECILIA
Other - Last Name:DAVA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHYSICAL THERAPIST
Mailing Address - Street 1:1201 W 96TH PL
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-1736
Mailing Address - Country:US
Mailing Address - Phone:219-308-3050
Mailing Address - Fax:
Practice Address - Street 1:1201 W 96TH PL
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-1736
Practice Address - Country:US
Practice Address - Phone:219-308-3050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-19
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist