Provider Demographics
NPI:1801247119
Name:DYNIA, MARIA (OTR)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:DYNIA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-2313
Mailing Address - Country:US
Mailing Address - Phone:860-930-3697
Mailing Address - Fax:
Practice Address - Street 1:245 AMITY RD
Practice Address - Street 2:SUITE 207
Practice Address - City:WOODBRIDGE
Practice Address - State:CT
Practice Address - Zip Code:06525-2258
Practice Address - Country:US
Practice Address - Phone:203-389-8177
Practice Address - Fax:203-387-9447
Is Sole Proprietor?:No
Enumeration Date:2016-06-28
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4632225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand