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NPI Code Detail

MEDICARE: AMANDA M CARMICHEAL OT

MEDICARE: AMANDA M CARMICHEAL OT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist1244NE

General Provider Information

NPI Number : 1760553804
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA M CARMICHEAL OT
Provider Business Mailing Address
First Line : 10355 S 97TH ST
Second Line :
City : PAPILLION
State : NE
Zip : 68046-4930
Country : US
Telephone Number : 402-651-6835
Fax Number :
Provider Business Practice Location Address
First Line : 101 E STATE ST
Second Line :
City : KENNETT SQUARE
State : PA
Zip : 19348-3109
Country : US
Telephone Number : 402-201-2208
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/12/2006
Last Update Date : 11/16/2021

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