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NPI Code Detail

MEDICARE: AMBER WILLETT OTR/L

MEDICARE: AMBER WILLETT OTR/L
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
1225XP0200XPediatric Occupational Therapist281121KY
2225X00000XOccupational Therapist

General Provider Information

NPI Number : 1851000434
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMBER WILLETT OTR/L
Provider Business Mailing Address
First Line : 9209 WANLOU DR
Second Line :
City : LOUISVILLE
State : KY
Zip : 40272-2766
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1901 COMMONWEALTH CT UNIT B
Second Line :
City : LOUISVILLE
State : KY
Zip : 40299-2355
Country : US
Telephone Number : 502-458-9978
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2022
Last Update Date : 11/28/2022

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