Provider Demographics
NPI:1144551318
Name:HARRIS, AMY L (OTR/L)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:L
Last Name:HARRIS
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 1:2514 OLDE DUTCH CT
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28504-7533
Mailing Address - Country:US
Mailing Address - Phone:252-933-0182
Mailing Address - Fax:252-514-4512
Practice Address - Street 1:2514 OLDE DUTCH CT
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28504-7533
Practice Address - Country:US
Practice Address - Phone:252-933-0182
Practice Address - Fax:252-514-4512
Is Sole Proprietor?:No
Enumeration Date:2010-01-27
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7437225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist