Provider Demographics
NPI:1710216932
Name:CAMPBELL, AMANDA LYNN (OTR/L)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:LYNN
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:LYNN
Other - Last Name:BAUMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:495 UINTA WAY
Mailing Address - Street 2:SUITE 140
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-7110
Mailing Address - Country:US
Mailing Address - Phone:303-432-8487
Mailing Address - Fax:
Practice Address - Street 1:495 UINTA WAY
Practice Address - Street 2:SUITE 140
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-7110
Practice Address - Country:US
Practice Address - Phone:303-432-8487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-17
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119005008225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist