Provider Demographics
NPI:1245437904
Name:WARREN, AMANDA MARIE (OTR-L)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:MARIE
Last Name:WARREN
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 1:7101 HINTON MILL RD
Mailing Address - Street 2:
Mailing Address - City:OSTRANDER
Mailing Address - State:OH
Mailing Address - Zip Code:43061-9316
Mailing Address - Country:US
Mailing Address - Phone:614-309-9889
Mailing Address - Fax:
Practice Address - Street 1:2760 AIRPORT DR STE 160
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-2284
Practice Address - Country:US
Practice Address - Phone:614-228-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5905225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist