Provider Demographics
NPI:1962849224
Name:AMBUEHL, HOLLY DANIELLE (OTR, MOT)
Entity type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:DANIELLE
Last Name:AMBUEHL
Suffix:
Gender:F
Credentials:OTR, MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3331 CEMENT VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065-5312
Mailing Address - Country:US
Mailing Address - Phone:972-342-0704
Mailing Address - Fax:
Practice Address - Street 1:1002 LEGACY RANCH RD STE 104
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-1293
Practice Address - Country:US
Practice Address - Phone:214-980-1397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-28
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114591225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist