Provider Demographics
NPI:1700022969
Name:KITCHENS, AMY A (OTR)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:A
Last Name:KITCHENS
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 1:110 PATE ORR RD S
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-1400
Mailing Address - Country:US
Mailing Address - Phone:817-337-0162
Mailing Address - Fax:817-337-0235
Practice Address - Street 1:110 PATE ORR RD S
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-1400
Practice Address - Country:US
Practice Address - Phone:817-337-0162
Practice Address - Fax:817-337-0235
Is Sole Proprietor?:No
Enumeration Date:2008-12-18
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10951225X00000X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist