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General NPI Number Information
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NPI Number | 1609431949
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Entity Type | Individual
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Provider Name | MRS. AMANDA JANE SETTLES
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Gender | Female
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Dates
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Enumeration Date | 05/02/2019
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Last Update Date | 05/02/2019
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Provider Practice Location Address
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Address Line | 215 HERITAGE MANOR-STAUNTON
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City | STAUNTON
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State | IL
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Zip | 62088
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Country | US
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Telephone | 618-635-5577
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Fax |
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Provider Business Mailing Address
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Address Line | 348 NE 450 AVE
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City | CARROLLTON
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State | IL
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Zip | 62016-4453
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Country | US
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Telephone | 217-248-1435
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 057.005182
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License Number State | IL
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