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General NPI Number Information
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NPI Number | 1083161145
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Entity Type | Individual
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Provider Name | AMY ELIZABETH VILLALOBOS OT/R
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Gender | Female
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Dates
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Enumeration Date | 09/07/2016
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Last Update Date | 04/29/2021
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Provider Practice Location Address
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Address Line | 16 CONVERSE CIR
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City | EAST LONGMEADOW
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State | MA
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Zip | 01028-1906
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Country | US
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Telephone | 413-847-1212
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Fax |
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Provider Business Mailing Address
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Address Line | 16 CONVERSE CIR
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City | EAST LONGMEADOW
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State | MA
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Zip | 01028-1906
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Country | US
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Telephone | 413-847-1212
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 12191
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 225XN1300X
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Taxonomy Name | Neurorehabilitation Occupational Therapist
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License Number | 16542658
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 900839666
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 225XG0600X
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Taxonomy Name | Gerontology Occupational Therapist
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License Number | 12191
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License Number State | MA
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