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NPI Code Detail

MEDICARE: AMY HARRIS OTR, MSOT

MEDICARE: AMY HARRIS OTR, MSOT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational TherapistIN
2106S00000XBehavior Technician

General Provider Information

NPI Number : 1629629936
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY HARRIS OTR, MSOT
Provider Business Mailing Address
First Line : 3786 GRAY HEATHER LN
Second Line :
City : WHITESTOWN
State : IN
Zip : 46075-9786
Country : US
Telephone Number : 812-319-5749
Fax Number :
Provider Business Practice Location Address
First Line : 8702 FOUNDERS RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46268-1337
Country : US
Telephone Number : 317-452-9430
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2019
Last Update Date : 03/05/2025

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