Provider Demographics
NPI:1649599713
Name:LAWSON, AMY DENISE (OTR/L)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:DENISE
Last Name:LAWSON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:GORDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5715 CORBON CREST LN
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-6837
Mailing Address - Country:US
Mailing Address - Phone:919-827-6080
Mailing Address - Fax:
Practice Address - Street 1:77 S ELLIOTT RD
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-5827
Practice Address - Country:US
Practice Address - Phone:919-932-7266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-27
Last Update Date:2017-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5604225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation