Provider Demographics
NPI:1417188517
Name:DUBEY, AMY (OTR)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:DUBEY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:347 CREEKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-8676
Mailing Address - Country:US
Mailing Address - Phone:231-874-0080
Mailing Address - Fax:231-373-5459
Practice Address - Street 1:347 CREEKSIDE DR
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-8676
Practice Address - Country:US
Practice Address - Phone:231-487-0080
Practice Address - Fax:231-373-5459
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-06
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL1563580225X00000X
MI5201005376225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist