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General NPI Number Information
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NPI Number | 1477210334
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Entity Type | Individual
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Provider Name | DAFNA MAYA CHARLES MS, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 11/25/2021
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Last Update Date | 12/19/2023
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Provider Practice Location Address
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Address Line | 7007 DEXTER ANN ARBOR RD STE A
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City | DEXTER
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State | MI
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Zip | 48130-8568
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Country | US
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Telephone | 734-680-8800
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 412031
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City | BOSTON
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State | MA
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Zip | 02241-2031
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Country | US
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Telephone | 914-294-4050
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 025010
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 5201013690
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License Number State | MI
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