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General NPI Number Information
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NPI Number | 1497575781
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Entity Type | Individual
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Provider Name | AMY THOMAS TASMAN OTR/L
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Gender | Female
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Dates
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Enumeration Date | 10/12/2024
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 717 GOLDSBOROUGH ST
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City | EASTON
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State | MD
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Zip | 21601-4914
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Country | US
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Telephone | 443-995-1618
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Fax |
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Provider Business Mailing Address
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Address Line | 22526 GREAT OAK LANDING RD
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City | CHESTERTOWN
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State | MD
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Zip | 21620-4109
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Country | US
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Telephone | 267-251-0081
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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 | 10359
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License Number State | MD
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