Provider Demographics
NPI:1497575781
Name:THOMAS TASMAN, AMY (OTR/L)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:THOMAS TASMAN
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 1:22526 GREAT OAK LANDING RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21620-4109
Mailing Address - Country:US
Mailing Address - Phone:267-251-0081
Mailing Address - Fax:
Practice Address - Street 1:717 GOLDSBOROUGH ST
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-4914
Practice Address - Country:US
Practice Address - Phone:443-995-1618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-12
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10359225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist