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General NPI Number Information
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NPI Number | 1972220259
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Entity Type | Individual
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Provider Name | AMANDA COLLET OTR/L
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Gender | Female
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Dates
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Enumeration Date | 10/26/2022
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Last Update Date | 10/26/2022
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Provider Practice Location Address
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Address Line | 8199 MONROE DR
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City | LEWIS CENTER
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State | OH
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Zip | 43035-7761
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Country | US
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Telephone | 740-879-3181
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Fax |
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Provider Business Mailing Address
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Address Line | 5480 W BREESE RD
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City | LIMA
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State | OH
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Zip | 45806-9411
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Country | US
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Telephone | 474-036-1865
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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 |
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License Number State |
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