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General NPI Number Information
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NPI Number | 1104156223
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Entity Type | Individual
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Provider Name | AMY CATHERINE CULLEN OTR/L
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Gender | Female
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Dates
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Enumeration Date | 01/12/2010
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Last Update Date | 09/09/2012
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Provider Practice Location Address
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Address Line | 1235 POTOMAC AVE SE
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City | WASHINGTON
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State | DC
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Zip | 20003-4115
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Country | US
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Telephone | 703-309-7732
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Fax |
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Provider Business Mailing Address
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Address Line | 1235 POTOMAC AVE SE
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City | WASHINGTON
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State | DC
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Zip | 20003-4115
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Country | US
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Telephone | 703-309-7732
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OT010000561
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 0119004658
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License Number State | VA
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