Provider Demographics
NPI:1396085288
Name:DUNNAWAY, TAMERRIAL J (OT)
Entity type:Individual
Prefix:
First Name:TAMERRIAL
Middle Name:J
Last Name:DUNNAWAY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 BAKER DR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-3805
Mailing Address - Country:US
Mailing Address - Phone:561-693-8992
Mailing Address - Fax:
Practice Address - Street 1:319 BAKER DR
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-3805
Practice Address - Country:US
Practice Address - Phone:561-693-8992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-28
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13109225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist