Provider Demographics
NPI:1548546989
Name:DAURA, DAVINA C (MS, OTR/L)
Entity type:Individual
Prefix:MRS
First Name:DAVINA
Middle Name:C
Last Name:DAURA
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 ROUTE 15 NORTH
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:NJ
Mailing Address - Zip Code:07848
Mailing Address - Country:US
Mailing Address - Phone:973-862-6377
Mailing Address - Fax:
Practice Address - Street 1:156 ROUTE -15
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:NJ
Practice Address - Zip Code:07848
Practice Address - Country:US
Practice Address - Phone:973-237-1975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-31
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00460300225XP0200X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty