Provider Demographics
NPI:1962077586
Name:BLANTON, AMBER (OTR/L)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:BLANTON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1028 HOLT RD
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27523-9432
Mailing Address - Country:US
Mailing Address - Phone:919-818-7856
Mailing Address - Fax:
Practice Address - Street 1:1028 HOLT RD
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27523-9432
Practice Address - Country:US
Practice Address - Phone:919-818-7856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-25
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics