Individual
DANA E MOULTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L, CHT
Contact information
Practice address
6015 POINTE WEST BLVD, BRADENTON, FL 34209
(941) 591-0207
(941) 761-0712
Mailing address
6015 POINTE WEST BLVD, BRADENTON, FL 34209-5525
(941) 591-0207
(941) 761-0712
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
15765
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4BBN1
FL BCBS
FL
Enumeration date
07/14/2005
Last updated
12/04/2018
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