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General NPI Number Information
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NPI Number | 1528624038
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Entity Type | Organization
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Legal Business Name | AMANDA ANDERSON,OTR/L LLC
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Dates
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Enumeration Date | 05/10/2019
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Last Update Date | 05/10/2019
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Provider Practice Location Address
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Address Line | 162 ADAMS ST
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City | RUTLAND
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State | VT
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Zip | 05701-2901
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Country | US
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Telephone | 802-236-8123
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Fax | 802-881-0025
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Provider Business Mailing Address
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Address Line | 162 ADAMS ST
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City | RUTLAND
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State | VT
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Zip | 05701-2901
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Country | US
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Telephone | 802-236-8123
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Fax | 802-881-0025
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | MRS. AMANDA HALE ANDERSON
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Credential | OTR
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Telephone | 802-236-8123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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