Healthcare Provider Details

I. General information

NPI: 1255212544
Provider Name (Legal Business Name): AMANDA LEIGH DILTS OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2025
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

318 E BASIN RD
NEW CASTLE DE
19720-4214
US

IV. Provider business mailing address

318 E BASIN RD
NEW CASTLE DE
19720-4214
US

V. Phone/Fax

Practice location:
  • Phone: 302-429-4074
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberU1-0012774
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: