Healthcare Provider Details

I. General information

NPI: 1992129118
Provider Name (Legal Business Name): AMIE KUNKEL M.A. OT/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2014
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 30035
CHARLOTTE NC
28230-0035
US

IV. Provider business mailing address

18820 STATESVILLE RD
CORNELIUS NC
28031-6754
US

V. Phone/Fax

Practice location:
  • Phone: 980-343-3000
  • Fax:
Mailing address:
  • Phone: 866-757-1272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number18436
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: