Provider Demographics
NPI:1982335337
Name:GIFFORD, DANA (OTR/L, CBIS, CSRS)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:
Last Name:GIFFORD
Suffix:
Gender:F
Credentials:OTR/L, CBIS, CSRS
Other - Prefix:MS
Other - First Name:DANA
Other - Middle Name:
Other - Last Name:ROBERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5418 S 192ND RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HOPE
Mailing Address - State:MO
Mailing Address - Zip Code:65725-9185
Mailing Address - Country:US
Mailing Address - Phone:417-274-4292
Mailing Address - Fax:
Practice Address - Street 1:5904 S SOUTHWOOD RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-5234
Practice Address - Country:US
Practice Address - Phone:417-227-9000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-17
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitationGroup - Single Specialty