Provider Demographics
NPI:1437891314
Name:WATTS, AMBER MARIE (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:MARIE
Last Name:WATTS
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:GERDES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 343
Mailing Address - Street 2:
Mailing Address - City:ALBERS
Mailing Address - State:IL
Mailing Address - Zip Code:62215-0343
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:450 W 1ST ST
Practice Address - Street 2:
Practice Address - City:AVISTON
Practice Address - State:IL
Practice Address - Zip Code:62216-3440
Practice Address - Country:US
Practice Address - Phone:618-228-7615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-11
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist