Provider Demographics
NPI:1184803306
Name:SANDERS, AMY J (OTR)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:J
Last Name:SANDERS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22111 RUSTIC SHORES LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-5483
Mailing Address - Country:US
Mailing Address - Phone:281-579-7335
Mailing Address - Fax:
Practice Address - Street 1:22111 RUSTIC SHORES LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-5483
Practice Address - Country:US
Practice Address - Phone:281-579-7335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-25
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112437225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics