Provider Demographics
NPI:1033242417
Name:BUTTS, JAMIE MICHELLE (OT)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:MICHELLE
Last Name:BUTTS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:874 CLYDE BORUM RD
Mailing Address - Street 2:
Mailing Address - City:INWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:25428
Mailing Address - Country:US
Mailing Address - Phone:304-262-0014
Mailing Address - Fax:
Practice Address - Street 1:2720 CHARLES TOWN RD
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-5626
Practice Address - Country:US
Practice Address - Phone:304-263-0933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1178225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist