Provider Demographics
NPI:1386168151
Name:DODD, AMBER R (COTA/L)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:R
Last Name:DODD
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:R
Other - Last Name:SNYDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:8085 CRAWFORD LN
Mailing Address - Street 2:
Mailing Address - City:NEW CONCORD
Mailing Address - State:OH
Mailing Address - Zip Code:43762-9238
Mailing Address - Country:US
Mailing Address - Phone:740-801-0601
Mailing Address - Fax:
Practice Address - Street 1:116 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-5088
Practice Address - Country:US
Practice Address - Phone:740-801-0601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA.006963224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant