Provider Demographics
NPI:1174742928
Name:DICOLA, DINA
Entity type:Individual
Prefix:MRS
First Name:DINA
Middle Name:
Last Name:DICOLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 STARFLOWER CT
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02879-5475
Mailing Address - Country:US
Mailing Address - Phone:401-450-4944
Mailing Address - Fax:
Practice Address - Street 1:585 KINGSTOWN RD
Practice Address - Street 2:
Practice Address - City:SOUTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02879-3600
Practice Address - Country:US
Practice Address - Phone:401-284-4357
Practice Address - Fax:401-284-4358
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIOT00868225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist