Healthcare Provider Details

I. General information

NPI: 1053256362
Provider Name (Legal Business Name): AMANDA RUTH HELMS OTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N CHURCH ST
MONROE NC
28112-4804
US

IV. Provider business mailing address

1114 MILLWRIGHT LN
MATTHEWS NC
28104-2964
US

V. Phone/Fax

Practice location:
  • Phone: 704-282-6259
  • Fax:
Mailing address:
  • Phone: 704-282-6259
  • Fax: 704-296-3079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number4157
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: