Provider Demographics
NPI:1689985582
Name:LINK, AMY MARIE (COTA/L)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:MARIE
Last Name:LINK
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 1:1132 SHIMP DR
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:OH
Mailing Address - Zip Code:45822-1174
Mailing Address - Country:US
Mailing Address - Phone:567-644-5633
Mailing Address - Fax:
Practice Address - Street 1:243 MARION DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:OH
Practice Address - Zip Code:45331-2613
Practice Address - Country:US
Practice Address - Phone:937-548-3141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03464224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant