Provider Demographics
NPI:1942934690
Name:HELLERMANN, AMY JOY (COTA/L)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:JOY
Last Name:HELLERMANN
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:JOY
Other - Last Name:KEMPF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:32 PINNACLE POINT CT
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30132-6703
Mailing Address - Country:US
Mailing Address - Phone:631-275-0096
Mailing Address - Fax:
Practice Address - Street 1:32 PINNACLE POINT CT
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30132-6703
Practice Address - Country:US
Practice Address - Phone:631-275-0096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-10
Last Update Date:2022-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOTA1852224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant