Amanda Clark, COTA
Individual provider Active NPI Occupational Therapy Assistant · Fairview, TN
NPI 1992257281 · NPPES record last updated Aug 29, 2018
Key facts
- NPI
- 1992257281
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 2598 (TN)
- Practice address
- 7146 Bahne Rd
Fairview, TN 37062 - Phone
- (615) 418-5498
- NPI assigned
- Nov 2, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2598 | TN | MD | Professional Counselor |
| OTA.0001097 | CO | MD | Occupational Therapy Assistant |
| OTA16750 | FL | MD | Occupational Therapy Assistant |
| OTP-OTA-LIC-6114 | MT | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | OTA16750 | FL | |
| Occupational Therapy Assistant | 224Z00000X | OTA.0001097 | CO | |
| Occupational Therapy Assistant | 224Z00000X | OTP-OTA-LIC-6114 | MT | |
| Occupational Therapy Assistant | 224Z00000X | 2598 | TN | Yes |
Addresses
Primary practice location
7146 Bahne Rd
Fairview, TN 37062
Mailing address
7146 Bahne Rd
Fairview, TN 37062-8207
Phone (615) 418-5498
Other providers in Fairview, TN
- Linda C Burgess
- Jason L Cabler
- Shelbi Breanne Cameron
- Erin Castellaw
- Centerstone
- Teresa Marie Clark
- Joseph Cottone
- Covenant Medical Fairview, PC
- Kelly Lea Cox
- Austin Daugherty
All providers in Fairview, TN · Occupational Therapy Assistant in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 29, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.