Basic Information
| Provider Information | |||||||||
| NPI: | 1154662914 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | SIEGEL | ||||||||
| FirstName: | AMY | ||||||||
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| NamePrefix: | MRS. | ||||||||
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| Credential: | OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 303 PARKWAY DR NE | ||||||||
| Address2: | WELLNESS CENTER | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303121212 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4042654000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 303 PARKWAY DRIVE NE | ||||||||
| Address2: | WELLNESS CENTER | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303125166 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4042654000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/04/2013 | ||||||||
| LastUpdateDate: | 06/14/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225XP0019X | OT005640 | GA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Physical Rehabilitation | 225XP0200X | OT005640 | GA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics |
No ID Information.