Healthcare Provider Details

I. General information

NPI: 1366910101
Provider Name (Legal Business Name): AMANDA JOY VOLLMER OTRL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2018
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13095 PECOS ST
WESTMINSTER CO
80234-1020
US

IV. Provider business mailing address

10675 HOBBIT LN
WESTMINSTER CO
80031-2236
US

V. Phone/Fax

Practice location:
  • Phone: 720-972-5740
  • Fax:
Mailing address:
  • Phone: 616-648-7740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT.0005616
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: