Provider Demographics
NPI:1588095996
Name:DUNBAR-LEAVITT, DANA A (OTR/L)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:A
Last Name:DUNBAR-LEAVITT
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 1:37 W MALSTROM CT
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-7300
Mailing Address - Country:US
Mailing Address - Phone:801-824-7600
Mailing Address - Fax:
Practice Address - Street 1:37 W MALSTROM CT
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-7300
Practice Address - Country:US
Practice Address - Phone:801-824-7600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-11
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT363918-4201225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist