Healthcare Provider Details

I. General information

NPI: 1205846714
Provider Name (Legal Business Name): AMY M KAHRE OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 03/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 SPRINGFIELD ST
RIVERSIDE OH
45431-1084
US

IV. Provider business mailing address

4801 SPRINGFIELD ST
RIVERSIDE OH
45431-1084
US

V. Phone/Fax

Practice location:
  • Phone: 937-236-9965
  • Fax:
Mailing address:
  • Phone: 937-236-9965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number4581
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number7119
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: