Provider Demographics
NPI:1609951839
Name:MUSTARD, AMBER LEE (DOCTOR OF OTR/L)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:LEE
Last Name:MUSTARD
Suffix:
Gender:F
Credentials:DOCTOR OF OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1609 MURFREESBORO PIKE
Mailing Address - Street 2:SUITE E
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-2924
Mailing Address - Country:US
Mailing Address - Phone:615-361-6140
Mailing Address - Fax:615-361-6141
Practice Address - Street 1:1609 MURFREESBORO PIKE
Practice Address - Street 2:SUITE E
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217-2924
Practice Address - Country:US
Practice Address - Phone:615-361-6140
Practice Address - Fax:615-361-6141
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOT0000002963225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist