Healthcare Provider Details
I. General information
NPI: 1104091446
Provider Name (Legal Business Name): AMBER LYNN DEWEESE OTR/L, CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/28/2008
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4604 SAWMILL RD
COLUMBUS OH
43220-2247
US
IV. Provider business mailing address
340 POLARIS PKWY
WESTERVILLE OH
43082-7971
US
V. Phone/Fax
- Phone: 614-827-8700
- Fax: 614-827-8701
- Phone: 614-545-7900
- Fax: 614-545-7901
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | OT006678 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225XH1200X |
| Taxonomy | Hand Occupational Therapist |
| License Number | OT006678 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: