Provider Demographics
NPI:1619215498
Name:HAMBEL, AMANDA LYNNETTE (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:LYNNETTE
Last Name:HAMBEL
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9769 MARIETTA RD SE
Mailing Address - Street 2:
Mailing Address - City:NEW LEXINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43764-9101
Mailing Address - Country:US
Mailing Address - Phone:740-342-1737
Mailing Address - Fax:
Practice Address - Street 1:9769 MARIETTA RD SE
Practice Address - Street 2:
Practice Address - City:NEW LEXINGTON
Practice Address - State:OH
Practice Address - Zip Code:43764-9101
Practice Address - Country:US
Practice Address - Phone:740-342-1737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-29
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH175264101Y00000X
OHS.2005703104100000X
OH2622224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No104100000XBehavioral Health & Social Service ProvidersSocial Worker