Provider Demographics
NPI:1801261789
Name:DALEY, DEANNA (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:
Last Name:DALEY
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:
Other - Last Name:BURKE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6424 HILLCREST ST
Mailing Address - Street 2:
Mailing Address - City:MERCERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17236-9648
Mailing Address - Country:US
Mailing Address - Phone:717-387-2437
Mailing Address - Fax:
Practice Address - Street 1:154 N ARTIZAN ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:MD
Practice Address - Zip Code:21795-1104
Practice Address - Country:US
Practice Address - Phone:301-582-1711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-03
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA01895224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant