Provider Demographics
NPI:1144214024
Name:HOPF, DANA MEYER (OTR)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:MEYER
Last Name:HOPF
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 KUEBLER PL
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47546-2537
Mailing Address - Country:US
Mailing Address - Phone:812-482-9536
Mailing Address - Fax:812-481-9097
Practice Address - Street 1:1458 W DIVISION RD
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546-9777
Practice Address - Country:US
Practice Address - Phone:812-482-9536
Practice Address - Fax:812-481-9097
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-07
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31000115225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200117310BMedicaid