Provider Demographics
NPI:1902532641
Name:FEINER, DANA RAE
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:RAE
Last Name:FEINER
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 1:2041 N NEW JERSEY ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-1645
Mailing Address - Country:US
Mailing Address - Phone:810-459-1157
Mailing Address - Fax:
Practice Address - Street 1:4740 KINGSWAY DR STE 33
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46205-1521
Practice Address - Country:US
Practice Address - Phone:810-459-1157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10132402222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist