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NPI Code Detail

MEDICARE: MRS. AMANDA MICHELLE SNELGROVE COTA/L

MEDICARE: MRS. AMANDA MICHELLE SNELGROVE COTA/L
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
1224Z00000XOccupational Therapy Assistant000723CT

General Provider Information

NPI Number : 1841534146
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMANDA MICHELLE SNELGROVE COTA/L
Provider Business Mailing Address
First Line : 29 HIGHLAND AVE
Second Line :
City : MERIDEN
State : CT
Zip : 06451-5324
Country : US
Telephone Number : 203-974-1033
Fax Number : 203-397-3653
Provider Business Practice Location Address
First Line : 225 AMITY RD
Second Line :
City : WOODBRIDGE
State : CT
Zip : 06525-2206
Country : US
Telephone Number : 230-387-0076
Fax Number : 203-397-3653
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/27/2012
Last Update Date : 11/27/2012

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