Provider Demographics
NPI:1083861579
Name:YOUNG, AMY R (OTR/L)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:R
Last Name:YOUNG
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 HARRIS RD
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-2145
Mailing Address - Country:US
Mailing Address - Phone:603-888-1573
Mailing Address - Fax:
Practice Address - Street 1:55 HARRIS RD
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-2145
Practice Address - Country:US
Practice Address - Phone:603-888-1573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1984225X00000X
MEOT2152225X00000X
MA9562225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist