Provider Demographics
NPI:1851971709
Name:HOTHAM, AMY PRESCOTT (OTR/L)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:PRESCOTT
Last Name:HOTHAM
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 HOTHAM LN
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04222-5397
Mailing Address - Country:US
Mailing Address - Phone:207-329-3462
Mailing Address - Fax:
Practice Address - Street 1:2 DAVIS POINT LN UNIT 1A
Practice Address - Street 2:
Practice Address - City:CAPE ELIZABETH
Practice Address - State:ME
Practice Address - Zip Code:04107-2628
Practice Address - Country:US
Practice Address - Phone:207-767-9773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-13
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT4048225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist