Provider Demographics
NPI:1588472203
Name:CUFFIN, AMY LYNNE (OTR)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:LYNNE
Last Name:CUFFIN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1013 BOARDWALK ST
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065-6706
Mailing Address - Country:US
Mailing Address - Phone:214-906-0477
Mailing Address - Fax:
Practice Address - Street 1:1013 BOARDWALK ST
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:TX
Practice Address - Zip Code:76065-6706
Practice Address - Country:US
Practice Address - Phone:214-906-0477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-27
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105331225XE0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XE0001XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistEnvironmental Modification