Provider Demographics
NPI:1316290836
Name:DUNAMS, AZELLA (OTR/L)
Entity type:Individual
Prefix:
First Name:AZELLA
Middle Name:
Last Name:DUNAMS
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 1:1829 NEW HOLLAND RD STE 13
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19607-2229
Mailing Address - Country:US
Mailing Address - Phone:610-401-1547
Mailing Address - Fax:
Practice Address - Street 1:1829 NEW HOLLAND RD STE 13
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19607-2229
Practice Address - Country:US
Practice Address - Phone:610-401-1547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-22
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC010278225X00000X
MD05232225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist