Provider Demographics
NPI:1104376458
Name:GEDDES, AMY FLANAGAN (OT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:FLANAGAN
Last Name:GEDDES
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:FLANAGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20 COVAN CV
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-5518
Mailing Address - Country:US
Mailing Address - Phone:828-702-2058
Mailing Address - Fax:
Practice Address - Street 1:59 OAKDALE ST
Practice Address - Street 2:
Practice Address - City:BREVARD
Practice Address - State:NC
Practice Address - Zip Code:28712-3951
Practice Address - Country:US
Practice Address - Phone:828-966-9036
Practice Address - Fax:828-966-4538
Is Sole Proprietor?:No
Enumeration Date:2016-10-11
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3260225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist