Provider Demographics
NPI:1497231260
Name:DREON, AMBER LAUREN (MOTR/L)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:LAUREN
Last Name:DREON
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:888 RUSTIC VILLAGE LN
Mailing Address - Street 2:
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48362-2141
Mailing Address - Country:US
Mailing Address - Phone:248-568-7294
Mailing Address - Fax:
Practice Address - Street 1:4501 N BLAGG RD
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89060-1946
Practice Address - Country:US
Practice Address - Phone:775-751-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-16
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201009941225X00000X
CO0005399225X00000X
NVOT-2182225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist