Provider Demographics
NPI:1700290111
Name:SEMPLE-DORMER, YONNETTE E (OT)
Entity Type:Individual
Prefix:DR
First Name:YONNETTE
Middle Name:E
Last Name:SEMPLE-DORMER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11515 OLD LOTTSFORD RD
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2277
Mailing Address - Country:US
Mailing Address - Phone:508-577-0756
Mailing Address - Fax:
Practice Address - Street 1:1090 W SR 436
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-2921
Practice Address - Country:US
Practice Address - Phone:800-226-9917
Practice Address - Fax:800-224-6215
Is Sole Proprietor?:No
Enumeration Date:2014-06-13
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06572171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor