Provider Demographics
NPI:1972896058
Name:ROSS, AMY B (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:B
Last Name:ROSS
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 1:568 BLUE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-3604
Mailing Address - Country:US
Mailing Address - Phone:706-364-5262
Mailing Address - Fax:706-364-5263
Practice Address - Street 1:568 BLUE RIDGE DR
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-3604
Practice Address - Country:US
Practice Address - Phone:706-364-5262
Practice Address - Fax:706-364-5263
Is Sole Proprietor?:No
Enumeration Date:2011-05-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT003224225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist