Provider Demographics
NPI:1750267332
Name:WHITE, AMBERLEE J (OTR)
Entity type:Individual
Prefix:
First Name:AMBERLEE
Middle Name:J
Last Name:WHITE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7636 ELPINE GRAY DR
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38002-8540
Mailing Address - Country:US
Mailing Address - Phone:901-282-8393
Mailing Address - Fax:
Practice Address - Street 1:2025 SOUTHERN AVE
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71104-2016
Practice Address - Country:US
Practice Address - Phone:318-219-6064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist