Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XH1200X | Occupational Therapist - Hand | 17-02618 | KS |
Y | 225XH1200X | Occupational Therapist - Hand | 2009019126 | MO |
NPI | 1033349725 |
---|---|
Provider Name | Amy Beth Speer |
First Address | Chattanooga, TN 37421-2564 |
Second Address | Lees Summit, MO 64082-4606 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2009 |
Last Update Date | 29/01/2020 |