Provider Demographics
NPI:1619356581
Name:DUNN, AMANDA KRISTIN (OTR)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:KRISTIN
Last Name:DUNN
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 1:1902 JOHN STOCKBAUER DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-3796
Mailing Address - Country:US
Mailing Address - Phone:361-894-7387
Mailing Address - Fax:361-579-7480
Practice Address - Street 1:1902 JOHN STOCKBAUER DR
Practice Address - Street 2:SUITE 300
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-3796
Practice Address - Country:US
Practice Address - Phone:361-894-7387
Practice Address - Fax:361-579-7480
Is Sole Proprietor?:No
Enumeration Date:2015-05-26
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116201225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist