Provider Demographics
NPI:1730588294
Name:REESER, AMBER (OTR/L)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:REESER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:BASS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1377 MOTOR PARKWAY SUITE 307
Mailing Address - Street 2:
Mailing Address - City:ISLANDIA
Mailing Address - State:NY
Mailing Address - Zip Code:11749-1607
Mailing Address - Country:US
Mailing Address - Phone:631-580-5200
Mailing Address - Fax:631-580-5222
Practice Address - Street 1:680B KINGSBOROUGH SQUARE,
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320
Practice Address - Country:US
Practice Address - Phone:757-547-0434
Practice Address - Fax:757-547-0625
Is Sole Proprietor?:No
Enumeration Date:2014-08-20
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116345225X00000X
VA0119007504225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist