Provider Demographics
NPI:1407531528
Name:ELSNER, AMANDA LYNNE (OTD, OTR, CNS)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LYNNE
Last Name:ELSNER
Suffix:
Gender:F
Credentials:OTD, OTR, CNS
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:LYNNE
Other - Last Name:SWOFFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTD, OTR
Mailing Address - Street 1:9415 WAVING FIELDS DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77064-4575
Mailing Address - Country:US
Mailing Address - Phone:903-920-1134
Mailing Address - Fax:
Practice Address - Street 1:17200 TX-249 STE.150
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77064
Practice Address - Country:US
Practice Address - Phone:281-664-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-16
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX123625225XP0200X, 225X00000X
225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation