Provider Demographics
NPI:1568203586
Name:PRO-DAPT LLC
Entity type:Organization
Organization Name:PRO-DAPT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO / OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:PATIENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:CANTRELL
Authorized Official - Suffix:
Authorized Official - Credentials:MOT, OTR/L
Authorized Official - Phone:757-462-0878
Mailing Address - Street 1:1570 BATTERY HILL DR.
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23231-8140
Mailing Address - Country:US
Mailing Address - Phone:804-220-1355
Mailing Address - Fax:
Practice Address - Street 1:1570 BATTERY HILL DR.
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23231-8140
Practice Address - Country:US
Practice Address - Phone:804-220-1355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty