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General NPI Number Information
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NPI Number | 1790154805
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Entity Type | Individual
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Provider Name | AMANDA BARSTOW MOT
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Gender | Female
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Dates
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Enumeration Date | 09/18/2015
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 2600 JAMES RD STE 300
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City | GRANBURY
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State | TX
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Zip | 76049-3123
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Country | US
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Telephone | 817-910-8131
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Fax |
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Provider Business Mailing Address
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Address Line | 2245 SUNFISH PT
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City | BLUFF DALE
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State | TX
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Zip | 76433-4391
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Country | US
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Telephone | 402-382-5857
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 1784
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License Number State | NE
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