Bonita Faye Dalton, M.S.,OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

3109 Issued in AZ

Practice address

294 W Carlos Ave
Holbrook, AZ 86025-1846

Phone

(928) 524-2123

NPI assigned

Sep 20, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bo Dalton Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660694400000",
    "number": "1215034178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7782",
            "city": "SUN CITY",
            "state": "FL",
            "postal_code": "335867782",
            "telephone_number": "813-505-2518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "294 W CARLOS AVE",
            "city": "HOLBROOK",
            "state": "AZ",
            "postal_code": "860251846",
            "telephone_number": "928-524-2123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALTON",
        "first_name": "BONITA",
        "middle_name": "FAYE",
        "credential": "M.S.,OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "AZ",
            "license": "3109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807-208",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BO",
            "last_name": "DALTON",
            "credential": "M.S.,OTR/L",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Amity Craig, MS, CCC-SLP
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• Leighanne Gentile Ervien

• All providers in Holbrook, AZ
• Pediatric Occupational Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.