Provider Demographics
NPI:1053512988
Name:FOX, AMY ELIZABETH (OTR)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:ELIZABETH
Last Name:FOX
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:ZINNANTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:5656 MIDDLE LIBBY RD
Mailing Address - Street 2:
Mailing Address - City:PARADISE
Mailing Address - State:CA
Mailing Address - Zip Code:95969-5325
Mailing Address - Country:US
Mailing Address - Phone:530-520-0460
Mailing Address - Fax:
Practice Address - Street 1:269 CREEK RD
Practice Address - Street 2:
Practice Address - City:SPRING CITY
Practice Address - State:TN
Practice Address - Zip Code:37381-2637
Practice Address - Country:US
Practice Address - Phone:281-250-6694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6364870-4201225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist