Provider Demographics
NPI:1326161803
Name:DILLAMAN, JOYCE
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:
Last Name:DILLAMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24631 N MOSIERTOWN RD
Mailing Address - Street 2:
Mailing Address - City:EDINBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16412-4339
Mailing Address - Country:US
Mailing Address - Phone:814-853-9852
Mailing Address - Fax:
Practice Address - Street 1:2630 W 13TH ST
Practice Address - Street 2:
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004-2405
Practice Address - Country:US
Practice Address - Phone:440-576-9023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2024-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH012861225X00000X
PAOC-008231-L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty