Healthcare Provider Details

I. General information

NPI: 1366864472
Provider Name (Legal Business Name): AMY WHEADON MS, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2014
Last Update Date: 10/21/2026
Certification Date: 10/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 FOREST RIDGE DR STE 1
ROWLEY MA
01969-2151
US

IV. Provider business mailing address

28 FOREST RIDGE DR STE 1
ROWLEY MA
01969-2151
US

V. Phone/Fax

Practice location:
  • Phone: 978-356-0315
  • Fax: 978-777-2007
Mailing address:
  • Phone: 978-777-1122
  • Fax: 978-777-2007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number7585
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: