Provider Demographics
NPI:1962555359
Name:WATSON-GRACE, AMY (MOT, OTR/L)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:WATSON-GRACE
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2033 BELLFLOWER CT
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-8346
Mailing Address - Country:US
Mailing Address - Phone:614-361-2785
Mailing Address - Fax:
Practice Address - Street 1:2033 BELLFLOWER CT
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-8346
Practice Address - Country:US
Practice Address - Phone:614-361-2785
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT.004643225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist