MEDICARE: AMY HOMAN DEPOY OT/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
1	225X00000X	Occupational Therapist	0119000933	VA

General Provider Information

NPI Number	:	1992045421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY HOMAN DEPOY OT/L

Provider Business Mailing Address
First Line	:	2522 IRISH PATH
Second Line	:
City	:	ROCKINGHAM
State	:	VA
Zip	:	22802-1208
Country	:	US
Telephone Number	:	540-746-1899
Fax Number	:

Provider Business Practice Location Address
First Line	:	2522 IRISH PATH
Second Line	:
City	:	ROCKINGHAM
State	:	VA
Zip	:	22802-1208
Country	:	US
Telephone Number	:	540-746-1899
Fax Number	:

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

Provider Enumeration Date	:	02/20/2013
Last Update Date	:	04/03/2023

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