Healthcare Provider Details

I. General information

NPI: 1801701032
Provider Name (Legal Business Name): AMANDA MARIE ROBERS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3077 COUNTY ROAD O S
DELAVAN WI
53115-3203
US

IV. Provider business mailing address

3077 COUNTY ROAD O S
DELAVAN WI
53115-3203
US

V. Phone/Fax

Practice location:
  • Phone: 262-949-3170
  • Fax:
Mailing address:
  • Phone: 262-949-3170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: