Provider Demographics
NPI:1396975801
Name:WOODLEY, AMY LYNN (MS OTR/L)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LYNN
Last Name:WOODLEY
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:LYNN
Other - Last Name:PAWELEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS OTR/L
Mailing Address - Street 1:205 YORKSHIRE ROAD
Mailing Address - Street 2:HERITAGE EDUCATION PROGRAM
Mailing Address - City:TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14150
Mailing Address - Country:US
Mailing Address - Phone:716-876-3901
Mailing Address - Fax:
Practice Address - Street 1:205 YORKSHIRE ROAD
Practice Address - Street 2:HERITAGE EDUCATION PROGRAM
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14150
Practice Address - Country:US
Practice Address - Phone:716-208-9777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-17
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015707-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist