Provider Demographics
NPI:1972848745
Name:YOUNG, AMY M (OTR/L, CEAC, CAPS)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:M
Last Name:YOUNG
Suffix:
Gender:F
Credentials:OTR/L, CEAC, CAPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5908 EDNA AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21214-1805
Mailing Address - Country:US
Mailing Address - Phone:443-473-2030
Mailing Address - Fax:
Practice Address - Street 1:5908 EDNA AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21214
Practice Address - Country:US
Practice Address - Phone:443-473-2030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-05
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD4146225XG0600X
MD04146225XE0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XE0001XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistEnvironmental Modification
No225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology