Provider Demographics
NPI:1306213244
Name:VANN, DANA NICHELL RUFFIN (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:DANA
Middle Name:NICHELL RUFFIN
Last Name:VANN
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 1:5709 ALAN DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-1404
Mailing Address - Country:US
Mailing Address - Phone:202-258-6422
Mailing Address - Fax:
Practice Address - Street 1:5111 CONNECTICUT AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-2004
Practice Address - Country:US
Practice Address - Phone:202-966-0127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-26
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOT928225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist