Healthcare Provider Details

I. General information

NPI: 1346424801
Provider Name (Legal Business Name): JAMIE L. WINTER OTR, CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2007
Last Update Date: 05/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1825 FORTVIEW RD STE 103
AUSTIN TX
78704-7654
US

IV. Provider business mailing address

PO BOX 684986
AUSTIN TX
78768-4986
US

V. Phone/Fax

Practice location:
  • Phone: 512-444-4263
  • Fax: 512-444-4264
Mailing address:
  • Phone: 512-444-4263
  • Fax: 512-444-4264

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number111819
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number111819
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: