Provider Demographics
NPI:1720123953
Name:CAMPBELL, AMY (OT)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5959 FREEMAN RD
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-9017
Mailing Address - Country:US
Mailing Address - Phone:740-972-8729
Mailing Address - Fax:740-972-0238
Practice Address - Street 1:5959 FREEMAN RD
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-9017
Practice Address - Country:US
Practice Address - Phone:740-972-8729
Practice Address - Fax:740-972-0238
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT-02481225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist