Provider Demographics
NPI:1861564536
Name:HUFFINES, AMY MARIE (OTA)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:MARIE
Last Name:HUFFINES
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:MISS
Other - First Name:AMY
Other - Middle Name:MARIE
Other - Last Name:MINAVIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTA
Mailing Address - Street 1:116 MEADOWLARK AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:MD
Mailing Address - Zip Code:21771-5535
Mailing Address - Country:US
Mailing Address - Phone:301-829-2455
Mailing Address - Fax:
Practice Address - Street 1:301 RUSSELL AVE
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-2805
Practice Address - Country:US
Practice Address - Phone:301-216-4247
Practice Address - Fax:301-216-4249
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA01586224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant