Individual
DINA DISNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
538 WIGARD AVE, PHILADELPHIA, PA 19128-3145
(121) 528-0027
Mailing address
538 WIGARD AVE, PHILADELPHIA, PA 19128-3145
(121) 528-0027
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC015615
PA
225X00000X
Occupational Therapist
OT-2188
NV
Other
Enumeration date
12/16/2018
Last updated
01/03/2019
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