Individual
AMY M DELAWDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
280 PATTONSVILLE RD, JACKSON, OH 45640-9452
(740) 395-8868
(740) 395-8819
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 395-8805
(740) 395-8855
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0055577
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000289357
OH MEDICAID UNISON
—
01
—
3027710
MOLINA MEDICAID
OH
05
—
3027710
—
OH
05
—
3810016701
—
WV
01
—
P00787206
RAILROAD MEDICARE
—
Enumeration date
09/18/2008
Last updated
08/07/2014
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