Provider Demographics
NPI:1083689319
Name:MCLELLAND, AMY L (OTR/L,CHT)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:L
Last Name:MCLELLAND
Suffix:
Gender:F
Credentials:OTR/L,CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4806 TIMBER COMMONS DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-7161
Mailing Address - Country:US
Mailing Address - Phone:419-627-2526
Mailing Address - Fax:
Practice Address - Street 1:4806 TIMBER COMMONS DR
Practice Address - Street 2:SUITE A
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-7161
Practice Address - Country:US
Practice Address - Phone:419-627-2526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT-03766225X00000X
OH1011100242225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHMC4039611Medicare ID - Type Unspecified