Provider Demographics
NPI:1952681009
Name:ADAMSON, AMY M (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:M
Last Name:ADAMSON
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 1:2310 N AMARADO ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-1515
Mailing Address - Country:US
Mailing Address - Phone:316-409-1719
Mailing Address - Fax:316-722-0804
Practice Address - Street 1:2310 N AMARADO ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-1515
Practice Address - Country:US
Practice Address - Phone:316-409-1719
Practice Address - Fax:316-722-0804
Is Sole Proprietor?:No
Enumeration Date:2011-08-21
Last Update Date:2011-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-01597225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation