Provider Demographics
NPI:1316146855
Name:DUNN-BOTTORFF, AMY JERENE (OTR)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:JERENE
Last Name:DUNN-BOTTORFF
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:DUNN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2 COLEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-1472
Mailing Address - Country:US
Mailing Address - Phone:832-492-3421
Mailing Address - Fax:
Practice Address - Street 1:17200 ST LUKES WAY
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384-8007
Practice Address - Country:US
Practice Address - Phone:936-266-4116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-14
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110806225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist