MEDICARE: AMBER HOUNTZ MS,OTR

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
1	225X00000X	Occupational Therapist	31006011A	IN

General Provider Information

NPI Number	:	1821454232
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER HOUNTZ MS,OTR

Provider Business Mailing Address
First Line	:	8625 MALAGA DR APT 2B
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46250-3618
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8625 MALAGA DR APT 2B
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46250-3618
Country	:	US
Telephone Number	:	812-212-4551
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2016
Last Update Date	:	01/14/2016

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