Healthcare Provider Details

I. General information

NPI: 1356041768
Provider Name (Legal Business Name): AMANDA BLUHM OTD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2023
Last Update Date: 03/31/2023
Certification Date: 03/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3183 CABIN CREEK TRL
BILLINGS MT
59106-9688
US

IV. Provider business mailing address

3183 CABIN CREEK TRL
BILLINGS MT
59106-9688
US

V. Phone/Fax

Practice location:
  • Phone: 541-619-7201
  • Fax:
Mailing address:
  • Phone: 541-619-7201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOTP-OT-LIC-9619
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code225XM0800X
TaxonomyMental Health Occupational Therapist
License NumberOTP-OT-LIC-9619
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: