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General NPI Number Information
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NPI Number | 1376750711
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Entity Type | Individual
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Provider Name | DENA MARIE BISHOP
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Gender | Female
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 04/02/2018
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Provider Practice Location Address
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Address Line | 1818 HARDEN BLVD STE 160
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City | LAKELAND
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State | FL
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Zip | 33803-1824
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Country | US
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Telephone | 863-683-4726
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Fax |
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Provider Business Mailing Address
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Address Line | 1504 YORKSHIRE TRL
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City | LAKELAND
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State | FL
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Zip | 33809-6851
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Country | US
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Telephone | 863-398-5161
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OT 11498
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License Number State | FL
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