Provider Demographics
NPI:1255885380
Name:PATTON, AMY MICHELLE (OT)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:MICHELLE
Last Name:PATTON
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6416 STEER TRL
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-1241
Mailing Address - Country:US
Mailing Address - Phone:512-906-9105
Mailing Address - Fax:
Practice Address - Street 1:4310 BEE CAVES RD
Practice Address - Street 2:
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-6691
Practice Address - Country:US
Practice Address - Phone:512-347-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-05
Last Update Date:2016-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110559225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist