Provider Demographics
NPI:1972610087
Name:HOSEA, AMY JOHNSON (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:JOHNSON
Last Name:HOSEA
Suffix:
Gender:F
Credentials:OTD, 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:PO BOX 153
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:TN
Mailing Address - Zip Code:38372-0153
Mailing Address - Country:US
Mailing Address - Phone:731-607-5650
Mailing Address - Fax:731-926-3646
Practice Address - Street 1:135 JORDAN LANE
Practice Address - Street 2:
Practice Address - City:PARSONS
Practice Address - State:TN
Practice Address - Zip Code:38363
Practice Address - Country:US
Practice Address - Phone:731-607-5650
Practice Address - Fax:731-926-3646
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3637225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist