Provider Demographics
NPI:1831408723
Name:VAN DALEN, ALLISON DUBOIS (OTR/L)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:DUBOIS
Last Name:VAN DALEN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:989 KNOX ABBOTT DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:CAYCE
Mailing Address - State:SC
Mailing Address - Zip Code:29033-3346
Mailing Address - Country:US
Mailing Address - Phone:803-796-7421
Mailing Address - Fax:803-796-7422
Practice Address - Street 1:989 KNOX ABBOTT DR
Practice Address - Street 2:SUITE 400
Practice Address - City:CAYCE
Practice Address - State:SC
Practice Address - Zip Code:29033-3346
Practice Address - Country:US
Practice Address - Phone:803-796-7421
Practice Address - Fax:803-796-7422
Is Sole Proprietor?:No
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCOT.3728 OT225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist