Provider Demographics
NPI:1679809867
Name:LEWIS, AMBER (OT)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:DAHLHAUSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:200 BRULE ST BLDG 871
Mailing Address - Street 2:
Mailing Address - City:FORT KNOX
Mailing Address - State:KY
Mailing Address - Zip Code:40121-6100
Mailing Address - Country:US
Mailing Address - Phone:502-626-9732
Mailing Address - Fax:502-624-9406
Practice Address - Street 1:200 BRULE ST BLDG 871
Practice Address - Street 2:
Practice Address - City:FORT KNOX
Practice Address - State:KY
Practice Address - Zip Code:40121-6100
Practice Address - Country:US
Practice Address - Phone:502-626-9732
Practice Address - Fax:502-624-9406
Is Sole Proprietor?:No
Enumeration Date:2009-10-23
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR3836225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand